Topical Retinoid Treatment for Various Dry-eye Disorders

Scheffer C.G. Tseng, A. Edward Maumenee, Walter J. Stark, Irene H Maumenee, Allan D. Jensen, W. Richard Green, Kenneth R. Kenyon

Research output: Contribution to journalArticlepeer-review

Abstract

We evaluated the clinical efficacy of treating various dry-eye disorders using 0.01 % and 0.1 % (weight/weight) topical all-trans retinoic acid ointment. Twenty-two patients were selected and classified into four major groups: (1) keratoconjunctivitis sicca (6 patients; 11 eyes), (2) StevensJohnson syndrome (9 patients; 17 eyes), (3) ocular pemphigoid or druginduced pseudopemphigoid (3 patients; 6 eyes), and (4) surgery or radiationinduced dry eye (4 patients; 4 eyes), based on the criterion that they remained symptomatic even under maximum tolerable conventional medical and/or surgical therapies. The results indicated that squamous metaplasia with mucin deficiency secondary to goblet cell loss and keratinization may be the basis for the development of clinical symptoms and morbidities, as these epithelial abnormalities were invariably present before treatment. After treatment, all patients demonstrated clinical improvements in symptoms, visual acuity, rose Bengal staining, or Schirmer test. Most importantly, this topical vitamin A treatment caused the reversal of squamous metaplasia as evidenced by impression cytology. Therefore, this treatment may represent the first nonsurgical attempt to treat these disorders by reversing diseased ocular surface epithelium.

Original languageEnglish (US)
Pages (from-to)717-727
Number of pages11
JournalOphthalmology
Volume92
Issue number6
DOIs
StatePublished - Jan 1 1985

Keywords

  • Stevens-Johnson syndrome
  • drug-induced pseudopemphigoid
  • epithelial differentiation
  • impression cytology
  • keratinization
  • keratoconjunctivitis sicca
  • mucin deficiency
  • ocular pemphigoid
  • radiation-induced keratoconjunctivitis
  • retinoids
  • squamous metaplasia
  • treatment for dry-eye disorders

ASJC Scopus subject areas

  • Ophthalmology

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