건성각결막염 환자에서 스테로이드 점안 후 눈물 신경성장인자의 변화

Topical 0.1% Prednisolone Lowers Nerve Growth Factor Expression in Keratoconjunctivitis Sicca Patients

Purpose: To compare nerve growth factor (NGF) levels in tears and on the ocular surface of normal controls with those of non-Sjogren type keratoconjunctivitis sicca (KCS) subjects, and investigate the effect of 0.1% prednisolone eye drops on NGF levels in KCS patients. Methods: Baseline tear NGF levels were measured in 41 KCS patients and 23 healthy control subjects using enzyme-linked immunosorbent assays (ELISA). KCS patients received 0.1% prednisolone drops in one eye, and 0.1% hyaluronic acid drops in the other eye, three times daily for 28 days. Impression cytology (IC) and immunostaining for NGF on conjunctival epithelium was performed for both groups. Results: KCS patients were found to have higher baseline tear NGF concentrations compared to age- and sex- matched healthy control subjects (65.9±14.5 vs. 122.1±45.3, p<0.0001). In KCS patients, prednisolone treatment for 28 days resulted in a decrease in tear NGF levels, symptom scores and IC scores, whereas hyaluronic acid treatment had no such effect (68.2±25.0 pg/μg vs. 108.0±43.4 pg/μg, p<0.0001 for tear NGF/TP ratio; 2.16±1.01 vs. 3.39±1.50, p=0.0014 for symptom scale; 1.05±0.67 vs. 1.61±0.86, p=0.0317 for IC). Measurements taken at both 14 and 28 days indicate that neither prednisolone nor hyaluronic acid treatment affected BUT or Schirmer values. Conclusions: KCS patients showed elevated levels of tear NGF, which were decreased by treatment with 0.1% prednisolone. These data suggest that the ocular surface NGF may play an important role in ocular surface inflammation processes associated with dry eyes.