[Pharmacological correction of burning eye syndrome].

Abstract

Burning eye syndrome (BES) is a subtype of dry eye syndrome (DES) characterized by neuropathic pain that is resistant to conventional DES therapy aimed at restoring tear film stability. The lack of impact on the corneal neural pathways is the reason for ineffectiveness of such treatment.

Purpose: This study evaluated the effectiveness of a novel treatment regimen for BES.

Material and methods: The study included patients aged 18-45 years diagnosed with BES. The criterion for exclusion from the study was the presence of clinical signs of blepharitis, meibomian gland dysfunction, as well as existing rheumatologic or oncologic diseases. The follow-up period was 12 months. All patients underwent standard and specialized ophthalmic examinations. They were randomly assigned to two groups: group 1 received gabapentin combined with neuroprotective therapy (thioctic acid, ipidacrine, and B vitamins) and topical 0.4% hyaluronic acid (HA) four times daily, while group 2 received only tear substitution therapy with 0.4% HA four times daily. Treatment efficacy was assessed using subjective (the Russian version of the Central Sensitization Inventory (CSI-20) and Visual Analog Scale (VAS)) and objective (laser corneal confocal microscopy and tearscopy) evaluation methods. Therapeutic effectiveness was assessed at 3, 6, and 12 months.

Results: By the third month, patients in group 1 reported subjective improvement based on CSI-20 and VAS scores, while objective findings demonstrated decreased tear osmolarity, increased anisotropy coefficient of nerve fiber orientation, and an increase in nerve fiber length. No significant changes were observed in group 2 over the same period.

Conclusion: The proposed treatment regimen, incorporating gabapentin along with neuroprotective therapy (thioctic acid, ipidacrine, and B vitamins) and topical 0.4% HA, proved more effective in alleviating neuropathic pain in BES compared to isolated topical therapy.