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Chen M, Wei A, Ke B, Zou J, Gong L, Wang Y, Zhang C, Xu J, Yin J, Hong J. Combination of 0.05% Azelastine and 0.1% Tacrolimus Eye Drops in Children With Vernal Keratoconjunctivitis: A Prospective Study. Front Med (Lausanne) 2021; 8:650083. [PMID: 34604246 PMCID: PMC8484704 DOI: 10.3389/fmed.2021.650083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 08/18/2021] [Indexed: 11/29/2022] Open
Abstract
Aims: To compare the efficacy of the combination of 0. 05% azelastine and 0.1% tacrolimus eye drops with 0.1% tacrolimus monotherapy in pediatric patients with vernal keratoconjunctivitis (VKC). Methods: Prospective study. Seventy-six patients with VKC were randomized 1:1 into monotherapy group with 0.1% tacrolimus or combination therapy group with 0.1% tacrolimus and 0.05% azelastine. The Ocular Surface Disease Index (OSDI) scores and the signs of conjunctival hyperemia, corneal involvement, and palpebral conjunctiva papillae were assessed at baseline and at 1, 2, and 6 weeks after treatment. Results: Two groups were comparable in age, sex, duration of VKC, OSDI, and clinical signs of VKC at baseline. Significant improvements in OSDI score and clinical signs were observed in both groups at all follow-up visits (all p < 0.001), compared with baseline. The combination therapy group showed a larger decrease in OSDI score from baseline (10.30 ± 0.9) compared with monotherapy group (7.30 ± 0.7, p =0.0085) at 1 week. Greater improvements in conjunctival hyperemia and conjunctival papillae were identified in the combination therapy group, compared with in the monotherapy group, at all follow-up visits (all p < 0.05). The corneal involvement scores in the combination group is significantly lower than the monotherapy group at 2 weeks after the treatment (p = 0.0488). No severe adverse effect was found in either group during the study. Conclusions: Compared with a monotherapy of 0.1% tacrolimus, the combination of 0.05% azelastine and 0.1% tacrolimus eye drops lead to faster and greater improvements in clinical signs and symptoms of vernal keratoconjunctivitis in pediatric patients.
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Affiliation(s)
- Minjie Chen
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, Shanghai, China
- Key myopia Laboratory of NHC, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
| | - Anji Wei
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, Shanghai, China
- Key myopia Laboratory of NHC, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
| | - Bilian Ke
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jun Zou
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lan Gong
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, Shanghai, China
- Key myopia Laboratory of NHC, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
| | - Yan Wang
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, Shanghai, China
- Key myopia Laboratory of NHC, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
| | - Chaoran Zhang
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, Shanghai, China
- Key myopia Laboratory of NHC, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
| | - Jianjiang Xu
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, Shanghai, China
- Key myopia Laboratory of NHC, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
| | - Jia Yin
- Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, United States
| | - Jiaxu Hong
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, Shanghai, China
- Key myopia Laboratory of NHC, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
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Retrospective review on the use of topical cyclosporin a 0.05% for paediatric allergic conjunctivitis in Hong Kong Chinese. ScientificWorldJournal 2014; 2014:396987. [PMID: 25386595 PMCID: PMC4214101 DOI: 10.1155/2014/396987] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 09/17/2014] [Indexed: 11/23/2022] Open
Abstract
Purpose. To evaluate the efficacy of using topical cyclosporin A 0.05% (Restasis) for the treatment of paediatric allergic conjunctivitis. Methods. This retrospective study included consecutive cases of paediatric allergic conjunctivitis treated with Restasis between 2010 and 2013. Subjects with follow-up time less than 3 months after using Restasis were excluded. Itch severity score, symptom score, and sign score were compared before (baseline) and 3 months after using Restasis. Results. In 27 eyes of 14 patients (mean age 10.8 ± 3.2 years), 44.4% had allergic conjunctivitis, 33.3% had vernal keratoconjunctivitis, and 22.2% had atopic keratoconjunctivitis. The mean duration of ocular symptoms was 20.4 ± 13.2 months. 92.6% of subjects were using steroid eye drop before Restasis. After 3 months of topical Restasis, there were statistically significant reductions in the symptom, sign, and itch severity scores compared with baseline (all P ≤ 0.001) and 78.6% of subjects were able to be tapered off steroid eye drops.
Conclusion. Topical Restasis was effective and safe in significantly reducing ocular itchiness, sign, and symptom scores at 3 months after use in paediatric allergic ocular conditions.
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