Table 2

Topical treatment options for the control of ocular surface inflammation

Drug	Characteristics	Author, year (Ref.)
Corticosteroids	Fast action, highly effective, possible side effects, usually not for chronic use.	Marsh, 1999³¹ Pfulgfelder, 2004³² Aragona, 2013³³ Rolando, 2017³⁴
Cyclosporine A	Acts on T lymphocyte recruitment, delayed achievement of full therapeutic effect.	Sall, 2000³⁵ Leonardi, 2016³⁶
Tacrolimus	Acts on T lymphocyte recruitment, delayed achievement of full therapeutic effect.	Moscovici, 2012³⁷
Lifitegrast	Inhibits lymphocyte activation by blocking ICAM-1 and LFA-1 receptors.	Perez, 2016³⁸
Omega-3	Reduces the activation of pro-inflammatory cytokines, increases anti-inflammatory prostagliandins, promotes the resolution of inflammation (resolvins), improves nerve neuroprotection (neuroprotectins)	Li, 2010³⁹ Cortina, 2010⁴⁰
Non-steroidal anti-inflammatory drugs	Mediate the breakdown of arachidonic acid cascade; side effects are decreased corneal sensitivity and sporadic corneal melting; currently not strongly suggested.	Rolando, 2002⁴¹ Aragona, 2000⁴² Aragona, 2005⁴³
Doxycycline	Reduces MMP-9 expression, macrophage, interleukin 1β, interleukin 6 and TNF-alfa.	Zhang, 2014⁴⁴
Azithromycin	Restores the levels of carotenoids in meibum and decreases signs and symptoms of DED.	Foulks, 2013⁴⁵
Tear substitutes	Increase tear fluid clearance, reduce concentration of pro-inflammatory factors. Osmoprotection and increase autophagy (ie, trehalose)	Baudouin, 2013⁴⁶ Uchida, 2014⁴⁷ Sarkar, 2007⁴⁸ Fariselli, 2017⁴⁹
Nerve growth factor	Regenerates corneal nerve, improves tear secretion and epithelial cell turnover.	Coassin, 2005⁵⁰
Autologous serum	Improve tear stability, fluorescein and rose bengal staining scores as well as subjective symptom scores	Kojima, 2005⁵¹

DED, dry eye disease; ICAM-1, intercellular adhesion molecule 1; LFA-1, lymphocyte function-associated antigen 1; MMP-9, matrix metalloproteinase 9; TNF, tumour necrosis factor.