Diagnosis of Dry Eye Disease and Confirmation of Therapeutic Effects of Restasis® through the Tear Osmolarity Measurement

Tai-Jin Kim¹, M.D., Suk-Kyue Choi², M.D.

¹Department of Ophthalmology, College of Medicine, Inje University, Seoul Paik Hospital, Seoul, Korea
²Department of Ophthalmology, College of Medicine, Inje University, Ilsan Paik Hospital, Seoul, Korea

Objects: To evaluate the effect of 0.05% cyclosporine emulsion (Restasis®, Allergan Inc, USA) on tear osmolarity measured by TearLabTM in dry eye syndrome.

Methods: From patients diagnosed with dry eye syndrome, 0.05% cyclosporine emulsion and lubricant eye drop were administered to 100 eyes of 50 patients. Prospective study was enrolled with 29 patients of 58 eyes of no previous ocular surgical history (Non LASEK Group) and 21 patients of 42 eyes who were performed with LASEK (LASEK Group) previously. Each patients Based on ocular surface disease index (OSDI) symptoms questionnaire, Schirmer test without anesthesia, Tear film break up time (TBUT), osmolarity were evaluated. The clinical parameters and symptoms were checked before treatment and after 1, 2, 3 months of treatment.

Results: There were no statistically significant differences between LASEK and Non-LASEK group at initial diagnosis of dry eye. Ocular symptoms evaluated by OSDI symptoms questionnaire in LASEK and Non-LASEK group were started to improve after 1 month use of Restasis® and the tear osmolarity was lowered significantly (P<0.05). Therapeuctic effect of Restasis® explained by osmolarity was also well correlated with OSDI symptoms questionnaire after 1 month. The improvement of TBUT, Schirmer test were started after 1 month of treatment and the tear osmolarity was lowered significantly (P<0.05). Therapeuctic effect of Restasis® explained by osmolarity was also well correlated with TBUT, Schirmer test after 1 and 3 month of treatment respectively.

Conclusion: The measurement of osmolarity of tear film showed well correlation with other tests and OSDI which explains symptomatic improvement of patient. Therefore the therapeutic effect of Restasis can be explained by measuring tear osmolarity. Also, assessment of tear osmolarity provides objective, measurable test for determining improvement in dry eye patients.