Topical cyclosporine A (CsA) appears to be more effective than artificial tears, vehicle, and some other topical treatments for improving ocular surface disease (OSD) symptoms and clinical signs, according to a study.
Researchers conducted a literature search, analyzing randomized clinical trials (RCTs) comparing different CsA concentrations and other topical therapies.
Out of 583 identified RCTs, 48 met the inclusion criteria. Thirty trials demonstrated CsA’s superior efficacy regardless of concentration, while 13 trials found comparable results between CsA and alternative treatments, including artificial tears, tacrolimus, and fluorometholone. Topical cyclosporine A was associated with improved symptoms and clinical signs, such as ocular surface staining and goblet cell density.
However, inconsistencies in treatment effects on tear film function were noted. Ten trials carried a high risk of bias, and overall evidence quality ranged from low to moderate due to imprecision and study limitations.
Reference
Chidi-Egboka NC, Fan L, Qureshi M, et al. Evidence on the Use of Topical Ciclosporin for Ocular Surface Disease: A Systematic Review and Meta-Analysis. Clin Exp Ophthalmol. 2025;doi: 10.1111/ceo.14514. Epub ahead of print. PMID: 40056051.
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