This study compared the efficacy and safety of topical cyclosporine 0.05% versus fluorometholone 0.1% for treating vernal keratoconjunctivitis. Both treatments significantly reduced symptoms, but cyclosporine was safer as it did not increase intraocular pressure like fluorometholone. For mild cases of vernal keratoconjunctivitis, topical cyclosporine is equally effective as fluorometholone and safer due to no risk of increased intraocular pressure.
This study compared the efficacy and safety of topical cyclosporine 0.05% versus fluorometholone 0.1% for treating vernal keratoconjunctivitis. Both treatments significantly reduced symptoms, but cyclosporine was safer as it did not increase intraocular pressure like fluorometholone. For mild cases of vernal keratoconjunctivitis, topical cyclosporine is equally effective as fluorometholone and safer due to no risk of increased intraocular pressure.
This study compared the efficacy and safety of topical cyclosporine 0.05% versus fluorometholone 0.1% for treating vernal keratoconjunctivitis. Both treatments significantly reduced symptoms, but cyclosporine was safer as it did not increase intraocular pressure like fluorometholone. For mild cases of vernal keratoconjunctivitis, topical cyclosporine is equally effective as fluorometholone and safer due to no risk of increased intraocular pressure.
Journal Reading KERATOCONJUNCTIVITIS COMPARISON BETWEEN TOPICAL CYCLOSPORINE 0.05% AND FLUOROMETHOLONE 0.1% IN TERMS OF EFFICACY AND SAFETY
Verdi Danutirto - 112015242
Abstract This study was undertaken to evaluate and compare effiicacy and safety of topical solutions of cyclosporine and flurometholone in patients of vernal konjuctivitis Prospective study, double blind, comparative and interventional randomized controlled trial Patients vernal keratoconjunctivitis specific symptoms, signs and intraocular pressure were graded and measured repeatedly till 90th day In mild cases of VKC, topical Cyclosporine is equally effective as topical Fluorometholone and Cyclosporine is safer as there is no rise in intra ocular pressure Introduction Vernal keratoconjunctivitis (VKC) is a chronic recurrent noninfectious allergic disease generally affects children and young adults Topical corticosteroids have been in use for treatment of these cases as they relief quickly, but theres rapid recurrence of symptoms following their discontinuation. Theeres potential of adverse effect of corticosteroids such as secondary glaucoma, steroid induced cataract. Topical cyclosporine has been tried as first line therapy and been effective in both palpebral dan limbal forms of VKC Theres no literalure in comparison to topical steroids Aim of the study To evaluate the efficacy of topical cyclosporine (0.05%) as compared to topical Fluorometholone (0.1%) in treatment of vernal keratoconjunctivitis To evaluate the safety of topical cyclosporine (0.05%) as compared to topical Fluorometholone (0.1%) in treatment of vernal keratoconjunctivitis Methods Prospective, double blind, comparative and interventional randomized controlled trial (RCT) comparing the igns and symptoms of VKC patients receiving topical Cyclosporine (0.05%) or Fluorometholone (0.05%) Sample size of 43 patients was reached upon using confidence level 95%, sampling error +/- 10, and population 600 Patients of VKC were screened for inclusion and exclusion criteria It was ensured therere no VKC targeted therapy for one week before study After the washout period patients received complete ophtalmic examination including specific sign and symptoms, intraocular pressure using rebound tonometer (Icare; TiolatOy, Helsinki, Finland) againts Goldmans applanation tonometer Symptoms and signs were graded and score was calculated using grading Anterior segment evaluation done on day 0, 7,14, 30 and day 90 from the date of enrollment. One eye of every patient was randomly assigned to FLAREX 0.1% and other to CYCLOMMUNE 0.05% , the brand labels of these vials were removed and new lael affixed indicating R and L randomly. Given to patients withour outer carton During follow up, the patients were supplied with fresh drugs according to the treatment status Statistical analysis was done using MedCalc Version 11.4.20, compared using repeat measure ANOVA and significance was ficed at P= 0.05 RESULTS Total 56 patients were enrolled and 44 patients completed the study over a period of one year Thus were 44 eyes in each group 31 Male (70.5%) and 13 female (29.5%) Average age 10.6 years (range 5-20 years) Age distribution was not normal due to Kolmogorov-Smirnov test for normal distribution P=0.01 Theres clustering for cases in group 5-10 years (~55%) Discussion Disease has greater prevalence in males (70.45%) as compared to females (29.54%) this is concordance with other studies. Cyclosporine 0.05% have fast onset of action observable at 1 week and increasing relief in signs and symptoms (itcing, watering, discharge, limbal nodule, punctate keratitis, redness) is seen till 4 week time, when theres maximum effect. Cyclosporine eye drops used have no effect on intra ocular pressure Fluorometholone also have maximum effect in most symptoms and signs at 4 week time, except redness and photophobia (at day 14) no recurrences found during period Analysis of total signs and symptoms score (exluding the IOP) showed that eyes receiving Fluorometholone eye drops did better There was no statisically difference in two groups Safety concerns is tendency to increase intra ocular pressure as seen in the Fluorometholone group. This IOP has positive linear trend of 14.23 (P<0.001) with maximum IOP seen at the end of study at day 90 Average 4.7 mmHg Possibility of further rise in IOP cannot be ruled out to delevop steroid induced glaucoma Other safety concern are development of cataract and local infective lesions due to steroid drops, Cyclosporine may be a first line drug for VKC treatment to avoid the signt threatening side corticosteroids side effects. No rise in intraocular pressure First line treatment for moderate and severe cases Further study may be done to evaluate the combination or sequential use of cyclosporine and fluorometholone to decide the dose titration of these two individual drugs to reach optimum therapy DANKE!
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