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Ocular Surface Symposium Report
These symposia proceedings, and the Symposium itself, have been produced and paid for by Santen
Changing Paradigms of Treating Severe Keratitis in Dry Eye Disease
Proceedings of a Symposium Presented at the European Society of Ophthalmology 2015 Congress in
Vienna, Austria on 7 June 2015
Symposium Speakers: Christophe Baudouin, 1 Mourad Amrane, 2 Andrea Leonardi 3 and Gysbert van Setten 4
1. Quinze-Vingts National Ophthalmology Hospital, Paris, France; 2. Santen SAS, Evry, France;
3. Department of Neuroscience, Ophthalmology, University of Padua, Italy; 4. St Eriks Eye Hospital, Stockholm, Sweden
Abstract These proceedings are based on a symposium, presented at the European Society of Ophthalmology 2015 Congress in Vienna, Austria
on 8 June 2015. The symposium was arranged by Santen to bring together leaders in ophthalmology with the objective of exploring
advances in the treatment of severe keratitis in dry eye disease (DED). DED is a multifactorial disease of the tears and ocular surface that
results in symptoms of discomfort, visual disturbance and tear instability with potential damage to the ocular surface. Abnormalities at
the ocular surface can affect all tear dynamic components, resulting in a vicious cycle that reinforces/sustains DED. Ciclosporin (CsA)
is thought to exert an anti-inflammatory effect on ocular surface cells. This compound should be in the near future one of the principal
advances in the treatment of DED for blocking the vicious cycle of the disease. Extensive formulation development work has led to the
availability of a well-tolerated, stable cationic nanoemulsion, designated as Novasorb ® technology. This technology has been used in
the first European approved CsA 1 mg/mL eye drops emulsion (Ikervis ® ) for the treatment of severe keratitis in adult patients with DED,
which has not improved despite treatment with tear substitutes. Clinical trials involving over 900 patients have demonstrated a good
safety and tolerability profile and significant clinical efficacy of this formulation with a once-daily dosing regimen. CsA 1 mg/mL eye drops
were evaluated in the pivotal phase III SANSIKA study, which confirmed the positive benefit–risk profile of CsA 1 mg/mL eye drops for the
treatment of severe keratitis in DED. An assessment of ocular surface health requires: listening to the patient, the use of simple diagnostic
tools, an expertise in examination, including use of microscopy, and an up-to-date knowledge of current models of DED.
Keywords Dry eye disease (DED), ciclosporin, Ikervis ® , Novasorb ® technology, corneal fluorescein staining (CFS), keratitis, inflammation, SANSIKA
Disclosures: Christophe Baudouin is a consultant and has received research grants from Alcon, Allergan, Santen and Thea. Mourad Amrane is an employee of Santen.
Andrea Leonardi is a consultant for Alcon, Allergan, Santen, Thea and SIFI. Gysbert van Setten is a consultant to Santen.
Acknowledgements: Editorial assistance was provided by Catherine Amey at Touch Medical Media and funded by Santen.
Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any non-commercial use, distribution, adaptation
and reproduction provided the original author(s) and source are given appropriate credit.
Received: 10 September 2015 Published Online: 23 December 2015 Citation: European Ophthalmic Review, 2015;9(2):121–7
Correspondence: Christophe Baudouin, Quinze-Vingts National Ophthalmology Hospital, 28 Rue de Charenton, 75012 Paris, France. E: email@example.com
Support: The symposia proceedings, and the symposium itself, were produced and paid for by Santen. The views and opinions expressed are those of the authors and not
necessarily those of Santen. This article reports the proceedings of a sponsored satellite symposium held at the European Society of Ophthalmology 2015 Congress and, as
such, has not been subject to this journal’s usual peer-review process. The report was reviewed for scientific accuracy by the symposium speakers before publication.
Rationale for Anti-inflammatory Treatment in Severe Dry Eye
Quinze-Vingts National Ophthalmology Hospital, Paris, France
The Dry Eye Workshop, in 2007, defined dry eye disease (DED) as a
multifactorial disease of the tears and ocular surface that results in
symptoms of discomfort, visual disturbance and tear film instability,
with potential damage to the ocular surface. 1 The definition adds
that: “It is accompanied by increased osmolarity of the tear film
and inflammation of the ocular surface”. Tear dynamics depend on
complex interplays between the environment, the eyelids, lacrimal film,
conjunctiva and cornea. There are multiple manifestations of DED, both
aqueous deficient and evaporative classifications. 2,3 Aqueous deficient
DED includes Sjögren’s syndrome (primary and secondary), non-
Sjögren’s dry eye, lacrimal gland duct obstruction, reflex hyposecretion
and the use of systemic drugs, such as anti-histamines, beta-blockers,
antispasmodics, diuretics and some psychotropic drugs. Evaporative
DED may be divided into intrinsic and extrinsic conditions. Intrinsic
factors encompass Meibomian gland dysfunction, disorders of the lid
aperture and a low blink rate behaviour, whereas vitamin A deficiency,
Prescribing Information for Ikervis can be found on page 127
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