Topical cyclosporine: Are all indications justified?

摘要

Inflammation is involved in the pathogenic mechanism of most of the chronic ocular surface disorders. In fact, the ocular surface can be considered as an 'immunological' unit that works with the aim to protect the visual system from external and internal noxae. This exposes the ocular surface structures to a continuous, subclinical, inflammatory condition. In this way, the ocular surface acts as an anatomical and functional unit that maintains a controlled immunological protection against several stimuli, such as allergens, chemical or physical irritants, traumas and infections from the external environment. Normally, the ocular surface system can modulate the immunological -response to avoid possible negative consequences on its structures due to an 'exaggerated' response or chronic activation of the immune system. However, if the pro-inflammatory stimuli are prolonged or strong enough, they can induce morphological and functional ocular surface changes, which may lead to the maintenance of a chronic inflammatory status.