Efficacy of topical cysteamine in nephropathic cystinosis

Br J Ophthalmol. 2017 Sep;101(9):1234-1237. doi: 10.1136/bjophthalmol-2016-309278. Epub 2017 Jan 5.

Abstract

Purpose: The aim of this study is to evaluate the efficacy of topical cysteamine 0.55% eye drops in the treatment of corneal cystine crystal deposits in patients with nephropathic cystinosis.

Methods: Thirty-two patients with nephropathic cystinosis were prospectively included in the study. Patients with corneal cystinosis were treated with topical cysteamine 0.55% eye drops. They were examined before treatment, on each monthly visit and after treatment at the last follow-up. Photophobia was classified as grade 0 (none) for no photophobia, grade 1 (mild) for photophobia in bright light, grade 2 (moderate) for photophobia in room light and grade 3 (severe) for photophobia in dim light. Corneal cystine crystals were graded as grade 0=none, grade 1=1-10 crystals/mm2, grade 2=11-50 crystals/mm2, grade 3=more than 50 crystals/mm2. The main outcome measure was evaluation of photophobia and resolution of corneal cystine crystals.

Results: There were 13 male and 19 female patients. The mean age was 8 years with an age range of 8 months to 19 years. The mean follow-up period was 4.1 years with a range of 2-8 years. Improvement of photophobia was not clinically significant in symptomatic patients. Patients displayed statistically significant worsening of corneal cystine deposits during the follow-up period.

Conclusions: This study has shown that topical 0.55% cysteamine eye drops may have limited effects in decreasing the corneal cystine deposits in patients with severe forms of nephropathic cystinosis.

Trial registration number: NCT02766855, Results.

Keywords: Cornea; Genetics; Treatment Medical.

MeSH terms

  • Administration, Topical
  • Adolescent
  • Child
  • Child, Preschool
  • Corneal Diseases / diagnosis
  • Corneal Diseases / drug therapy*
  • Corneal Diseases / physiopathology
  • Cysteamine / administration & dosage*
  • Cystine Depleting Agents / administration & dosage*
  • Cystinosis / diagnosis
  • Cystinosis / drug therapy*
  • Cystinosis / physiopathology
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Ophthalmic Solutions
  • Photophobia / physiopathology
  • Prospective Studies
  • Treatment Outcome
  • Visual Acuity / physiology
  • Young Adult

Substances

  • Cystine Depleting Agents
  • Ophthalmic Solutions
  • Cysteamine

Associated data

  • ClinicalTrials.gov/NCT02766855
  • ClinicalTrials.gov/NCT02766855