Conjunctival impression cytology and tear‐film changes in patients with familial Mediterranean fever: authors’ reply

Editor, W e would like to thank Drs Lazar & Rothkoff (2009) for their interest in our recent article, which evaluated ocular surface changes in patients with familial Mediterranean fever (FMF) (Karalezli et al. 2009). We found that despite normal tear production, the ocular surface and tear-film functions of FMF patients differ from those of healthy individuals. We concluded that these changes might be related to the chronic inflammatory nature of FMF. Drs Lazar & Rothkoff stated that ocular surface changes in FMF patients might have resulted from the colchicine treament that they received. There are few case reports in the literature that report the delay of corneal wound healing in patients with FMF who are under colchicine treatment (Biedner et al. 1977; Alster et al. 1997; Leibovitch et al. 2003a, 2003b). However, there is no prospective randomized clinical study that evaluates the effect of colchicine on the ocular surface. Leibovitch et al. (2003a, 2003b) reported that very small quantities of colchicine were secreted in tears but they could not state whether the levels that were measured were in a toxic range. Further prospective randomized control-group studies are needed to confirm the effect of colchicine on the ocular surface and its correlation with the amount and duration of colchicine treatment.