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Short-term results of a pulsed therapy with hydrocortisone eye drops to treat moderate to severe dry eye in primary Sjögren syndrome patients

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Abstract

Background

We investigated the safety and efficacy of short-term treatment with topical low-dose hydrocortisone sodium phosphate 0.335% (PFH) in patients with moderate to severe primary Sjögren syndrome (SS)-related dry eye disease (DED).

Methods

A retrospective single-centre interventional study. All patients received PFH for 6 days with a pulsed posology: three times daily for 2 days, twice daily for 2 days, and once daily for 2 days. This scheme was repeated for 3 consecutive months and then alternated for 3 months. Data were collected at baseline, 3 months, and 6 months of follow-up.

Results

A total of 40 SS patients were enrolled. Conjunctival hyperaemia and corneal-conjunctival stain significantly improved (p < 0.001). Ocular Surface Disease Index score reduced significantly between baseline and 3 months and between baseline and 6 months (p < 0.001). The tear film osmolarity lowered significantly in each eye from baseline to 3 months and from baseline to 6 months (p = 0.002 and p = 0.037, respectively).

Comparing results at 3 and 6 months, the Ocular Surface Disease Index score (p = 1.000), the frequency of lacrimal substitutes installation (p = 0.632), and tear film osmolarity (right eye p = 0.518, left eye p = 1.000) did not change significantly. Intraocular pressure did not change during the study period.

Conclusion

PFH eye drops with a pulsed posology improve signs and symptoms, not affecting the intraocular pressure in SS-related DED. Therefore, this pulsed treatment is safe and efficacious.

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Authors and Affiliations

  1. Ophthalmology, Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi, 10, 56126, Pisa, Italy

    Martina Menchini, Francesco Sartini, Michele Figus & Giovanna Gabbriellini

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  1. Martina Menchini
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  2. Francesco Sartini
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Correspondence to Martina Menchini.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the (CEAVNO, Comitato Etico Area Vasta Nordovest, register number: ID19847) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Menchini, M., Sartini, F., Figus, M. et al. Short-term results of a pulsed therapy with hydrocortisone eye drops to treat moderate to severe dry eye in primary Sjögren syndrome patients. Graefes Arch Clin Exp Ophthalmol 261, 1029–1036 (2023). https://doi.org/10.1007/s00417-022-05840-1

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