Konsensus dotyczący stosowania cyklosporyny A u pacjentów z ciężkim zapaleniem rogówki w przebiegu zespołu suchego oka w okulistyce, reumatologii i hematologii

CONTENT OF THE CONSENSUS STATEMENT

In December 2019, clinical experts in the fields of ophthalmology, rheumatology and hematology held a meeting in order to develop guidelines for the prevention and treatment of severe forms of dry eye syndrome (DES). During the meeting, an extremely important therapeutic problem was highlighted; namely the lack of patient access to reimbursed cyclosporin A. In light of above, a Consensus Statement was drawn up regarding the unavailability of sight-saving therapy in the form of reimbursed cyclosporin A to patients with severe DES.
The Consensus Statement was developed with references to the latest guidelines for the treatment of DES, including Polish Ophthalmological Society 2018 [1], TFOS DEWS II [2-5], AAO 2018 [6], EULAR 2020 [7], EBMT 2019 [8], and the publication “Prevention and Treatment of Severe Keratitis in Dry Eye Syndrome” [9]. During the development of the experts’ position, the opinion of dr. n. farm. Leszek Borkowski was taken into account in the section addressing the safety of medicinal products with cyclosporin [10].
Dry eye syndrome is a complex disorder characterized by inflammation, and instability and hyperosmolarity of the tear film. Severe forms of DES can lead to significant damage to the structures of the ocular surface (including severe keratitis), and neurosensory abnormalities.
Even though DES significantly reduces the quality of life of patients, it tends to be trivialized as a public health problem, despite the condition being one of the most common reasons to see an ophthalmologist. When providing their medical history, patients typically report a range of persistent symptoms including burning sensation, discomfort, itching, visual disturbances, irritation, photosensitivity, gritty feeling in the eyes, excessive tearing, and difficulty reading, driving, and working at the computer. The seriousness of the health problem is reflected in the fact that the lack of patient access to reimbursed treatment contributes to progression of the disease, ultimately resulting in ocular damage. The longer the period from the onset of DES symptoms to the diagnosis, the higher the severity of daily discomfort and pain, and the greater the adverse impact of the disease on the overall quality of life and professional activity of patients. The negative effect of moderate to severe DES on the quality of life of affected individuals is comparable to that of conditions requiring dialysis...


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