Effects Of 0.05% Cyclosporine A Eye Drops On Ocular Surface Microbiome In Patients With Mild To Moderate Dry Eye Syndrome

Purpose: To evaluate the effect of 0.05% cyclosporine A eye drops combined with 0.3%sodium hyaluronate eye drops for 3 months on ocular surface microbiota in patients with mild to moderate dry eye.Methods: In this study,14 patients(28 eyes)diagnosed with dry eye syndrome were enrolled.All patients used 0.05% cyclosporine A eye drops twice a day combined with0.3% sodium hyaluronate eye drops four times a day for three consecutive months.The ocular surface parameters and tear samples were detected before using the medication,six weeks and three months after using the medication.The test indexes included the scores of the Chinese Dry Eye Questionnaire,Schirmer’s Ⅱ test,inferior corneal staining scores(ICSS),fluorescein staining tear film breaking time(FBUT),noninvasive tear breakup time-average(NITBUT-av),tear meniscus height(TMH)and ocular redness index(ORI).Also,the differences of ocular surface microbiome were compared by using the 16 S r RNA gene sequencing technology.Results: After 3 months of continuous treatment,CDEQ(P=0.015),Schirmer’s Ⅱ test(P=0.009),FBUT(P < 0.001),ICSS(P < 0.001)were significantly improved after treatment.However,TMH(P=0.18),NBUT-AV(P=0.08)and ORI(P=0.337)were not significantly different in this study.The results of 16 s RNA gene sequencing showed that alpha diversity,beta diversity and bacterial abundance were not significantly different between V1 and V3,but the biomarkers Nitrospira and Chloroflexi were found in V1,and Fusobacteria and TM7 were found in V3.Conclusion: Topical application of 0.05% cyclosporine A eye drops twice A day combined with 0.3% sodium hyaluronate eye drops four times a day can effectively relieve the symptoms and signs of dry eye,and confirm the therapeutic effect of cyclosporine A eye drops.However,in the course of our study,no difference in the composition of the ocular surface microbiota was found between the two groups,but there were different biomarkers in the two groups,which may serve as potential predictive targets to identify the therapeutic effect of cyclosporine A.