Poster 76

Topical 0.05% Cyclosporine: Effect on the Quality ofLife of Dry Eye PatientsRobert Lopez, O.D. Dr. Lopez is currently in privatepractice at 5841 South Maryland, Chicago, Illinois 60605

Purpose: The purpose of this poster is to assess the efficacyof topical 0.05% cyclosporine (Restasis®) versus vehicle(Endura) for the improvement of dry eye signs and changein daily activity impact of dry eye.Methods: Prospective clinical evaluation of 56 patients withdry eye syndrome was performed. Schirmer testing withanesthesia, noninvasive fluorescein break-up time, and oc-ular surface vital dye staining were performed and theOcular Surface Disease Index (OSDI) was administered.Patients were randomized to either 0.05% cyclosporinetwice a day or vehicle twice a day for 3 months. Study visitswere at baseline and months 1, 2, and 3.Results: Cyclosporine improved OSDI scores significantlymore than vehicle (mean reduction of 11.4 points withcyclosporine, compared with a mean increase of 0.8 pointwith tears, P � 0.001). Dry eye ocular surface parametersalso improved significantly with cyclosporine treatmentcompared with vehicle. Cyclosporine provided statisticallysignificantly greater improvements in Schirmer’s scores(mean improvement of 1.4 mm, compared with a meanimprovement of 0.3 mm with vehicle, P � 0.001) and tearbreak-up time (mean improvement of 1.7 seconds withcyclosporine, compared with 0.4 seconds with vehicle (P �0.001) compared with vehicle. There were no statisticallysignificant differences in staining.Conclusions: The findings of the present study suggest thattopical cyclosporine effectively treats dry eye and providespositive change in daily activity impact of dry eye.

POSTERIOR SEGMENT

Poster 77

Clinical Findings and Management of InterferonAssociated RetinopathyBhagya Segu, O.D., and Pat Segu, O.D., VA HospitalHouston, 3301 Knollcrest Lane, Pearland, Texas 77584

Background: Chronic infection with hepatitis C virus(HCV) is estimated to affect 4 million people in the UnitedStates and 170 million individuals worldwide. Interferon(IFN), a group of proteins with antiviral properties, iscurrently the primary effective treatment available for HCV.Potential complications of interferon therapy include retinalhemorrhages and cotton wool spots that typically occur 2weeks after the initiation of treatment and resolve during thecourse of therapy. Visual disturbance leading to permanentvision loss has been reported in the literature as a result ofatypical complications from interferon treatment. The riskfor development of atypical complications increases in pa-tients with diabetes and hypertension.Case Report: A 51-year-old man came to the VeteransAdministration eye clinic for an ocular health examination.

The patient had completed 16 weeks of a 48-week course ofIFN treatment for chronic hepatitis C. The patient reportedno visual symptoms and had no previous history of retinop-athy. Dilated examination revealed cotton wool spots tem-poral to the disk O.S. and along the temporal arcades O.D.Because the patient’s medical history did not include dia-betes or hypertension, the cotton wool spots were attributedto the IFN treatment. The patient was scheduled for a2-month dilated examination.Conclusion: The development of interferon retinopathydepends on a variety of factors. Retinopathy is usuallytemporary and generally benign; however, ocular toxicityresulting in permanently impaired vision can occur. Allpatients should have a baseline fundus examination be-fore the initiation of interferon therapy and subsequentlybe followed every 3 to 6 months during treatment. Pa-tients with pre-existing retinopathy, or patients in whomretinopathy develops during the course of treatmentshould be followed more closely. This poster will explorethe potential ocular complications of interferon treatmentfor hepatitis C.

Poster 78

Multiple Diffuse Choroiditis with Panuveitis,Complicated with Secondary Inflammatory Open AngleGlaucoma Both EyesAdina Zapodeanu, O.D., Northeastern State University,College of Optometry, 1001 North Grand Avenue,Tahlequah, Oklahoma 74464

Background: Uveitis, in general, is the third leading causeof preventable blindness in the United States. The compli-cations that may cause blinding disease are: cystoid macularedema, cyclitic membranes with hypothony, and trabeculardamage with glaucoma.Case Report: I will present the case of a 60-year-old womanwith multiple diffuse choroiditis with panuveitis, compli-cated with secondary inflammatory open-angle glaucoma inboth eyes. When I saw the patient, the slit-lamp examinationrevealed the presence of the anterior uveitis. The dilatedfundus examination and fundus photographs showed thecharacteristic aspect of intermediate uveitis and the pres-ence of one of the white dot syndromes. We ordered bloodtests and chest X-ray examination to try to find an etiologyof the panuveitis. Fluorescein angiography and electroreti-nogram ruled in the diagnosis of multiple diffuse choroiditiswith panuveitis. Gonioscopy helped us categorize the pa-tient’s glaucoma in secondary inflammatory open-angleglaucoma.Methods: The patient was treated with oral prednisone withstill low-grade chronic inflammation present. We decidedon subtennon injection with Kenalog for both eyes. Thistreatment, after more than 3 months of followup, keeps theintraocular inflammation down, silent, and the intraocularpressure in very good control. During the last 6 months, thepatient’s refraction has had first 1 diopter of myopic shift,

296 Optometry, Vol 77, No 6, June 2006