Table 2

Topical treatment options for the control of ocular surface inflammation

DrugCharacteristicsAuthor, year (Ref.)
CorticosteroidsFast action, highly effective, possible side effects, usually not for chronic use.Marsh, 199931
Pfulgfelder, 200432
Aragona, 201333
Rolando, 201734
Cyclosporine AActs on T lymphocyte recruitment, delayed achievement of full therapeutic effect.Sall, 200035
Leonardi, 201636
TacrolimusActs on T lymphocyte recruitment, delayed achievement of full therapeutic effect.Moscovici, 201237
LifitegrastInhibits lymphocyte activation by blocking ICAM-1 and LFA-1 receptors.Perez, 201638
Omega-3Reduces 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 drugsMediate 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
DoxycyclineReduces MMP-9 expression, macrophage, interleukin 1β, interleukin 6 and TNF-alfa.Zhang, 201444
AzithromycinRestores the levels of carotenoids in meibum and decreases signs and symptoms of DED.Foulks, 201345
Tear substitutesIncrease 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 factorRegenerates corneal nerve, improves tear secretion and epithelial cell turnover.Coassin, 200550
Autologous serumImprove tear stability, fluorescein and rose bengal staining scores as well as subjective symptom scoresKojima, 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.