Retrospective Review on the Use of Topical Cyclosporin A 0.05% for Paediatric Allergic Conjunctivitis in Hong Kong Chinese

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 age10.8±3.2years), 44.4% had allergic conjunctivitis, 33.3% had vernal keratoconjunctivitis, and 22.2% had atopic keratoconjunctivitis. The mean duration of ocular symptoms was20.4±13.2months. 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 (allP≤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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The Efficacy of Topical 0.03% Tacrolimus Dermatologic Ointment in Treatment of Vernal Keratoconjunctivitis

Life and Science ◽

10.37185/lns.1.1.142 ◽

2021 ◽

Vol 2 (4) ◽

pp. 6

Author(s):

Muhammad Adnan ◽

Amena Masrur ◽

Furqan Ahmed Khan ◽

Ali Tayyab

Keyword(s):

Vernal Keratoconjunctivitis ◽

Eye Drops ◽

Slit Lamp ◽

Night Time ◽

The Mean ◽

Preservative Free

Objective: To determine the efficacy of 0.03% Tacrolimus dermatologic ointment in the treatment of Vernalkeratoconjunctivitis.Study Design: Cross-sectional.Place and Duration of Study: The study was conducted at Eye Donors Association Hospital, Wah Cantonmentfrom August 2019 to January 2020.Materials and Methods: 103 diagnosed patients ofvernal keratoconjunctivitis, aged 3-16 years, were includedin this study. They were treated with 0.03% Tacrolimus dermatologic ointment,applied in the inferior fornixonce at night time, for a period of two months. In addition, these patients were also prescribeda topical antihistamine(0.05 % ketotifen eye drops 3 times a day)and preservative free artificial tearsfor symptomatic relief.The patients were evaluated at 4 and 8 weeks after the initiation of treatment. At each follow up the clinicalsigns were assessed on a slit lamp biomicroscope by a single observer and recorded on a standardized gradingsheet.Results: Out of 103 patients, 66% were male and mean age was 9 years (range 3-16 years). The mean baselinescores showed a statistically significant decrease, with the exception of palpebral follicles & limbal Trantas dotsafter 8 weeks of treatment.Conclusion: 0.03% Tacrolimus dermatologic ointment was found to be safe and effective in the treatment ofvernal kerato-conjunctivitis.

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Prospective, Randomised, Double-Masked Comparison of 0.1% Tacrolimus Ointment and 0.2% Olopatadine Eye Drops in the Treatment of Refractory Allergic Conjunctivitis

10.21203/rs.3.rs-394712/v1 ◽

2021 ◽

Author(s):

Shivananda Narayana ◽

Ashish Khodifad ◽

Bharat Gurnani ◽

Kirandeep Kaur

Keyword(s):

Side Effects ◽

Allergic Conjunctivitis ◽

Eye Drops ◽

Topical Tacrolimus ◽

Conjunctival Hyperaemia ◽

Long Term Treatment ◽

Group A ◽

The Mean ◽

Group B

Abstract Purpose- To analyse and compare the outcomes of topical tacrolimus 0.1% and 0.2 % olopatadine eye drops in refractory allergic conjunctivitis.Methods-Prospective, double masked, randomized control trial conducted from January to December 2015 at a tertiary eye care centre with a follow up of 3 months. A total of 100 patients were enrolled. Fifty patients were allocated into the tacrolimus group (Group A) and olopatadine group (Group B) each. Detailed demographics, systemic history, uncorrected, best corrected visual acuity, intraocular pressure (IOP), anterior and posterior segment findings were recorded. Subjective symptoms and objective signs were recorded in the data forms at baseline and 1, 4, 8 & 12 weeks. The score of the worse eye was considered for analysis. On follow up, vision, IOP, side effects, objective signs and symptoms were recorded.Results- Out of 100 patients, 4 were lost to follow up. The mean age in Group A was 18.63 ± 7.89 years and Group B was 17.21 ± 9.17 years. The M:F ratio was 1.5:1. Among 96 patients, 6 (6.66%) had allergic rhinitis and 3 (3.33%) were asthmatic. The mean sign score, symptom score, giant papillae score, palpebral conjunctival hyperaemia and bulbar conjunctival hyperaemia score was statistically significant between two groups. In Group A, 22.9% patients had punctate epithelial erosions while none had in Group B at 1 month follow up.Conclusion- Topical tacrolimus 0.1% is safe and effective with minimal side effects. It should be considered for patients refractory to conventional treatment or requiring long term treatment, to avoid steroid related complications.

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Use of Plasma Rich in Growth Factors and ReGeneraTing Agent Matrix for the Treatment of Corneal Diseases

Vision ◽

10.3390/vision5030034 ◽

2021 ◽

Vol 5 (3) ◽

pp. 34

Author(s):

Ronald M. Sánchez-Ávila ◽

Edmar Uribe-Badillo ◽

Carlos Fernández-Vega González ◽

Francisco Muruzabal ◽

Borja de la Sen-Corcuera ◽

...

Keyword(s):

Growth Factors ◽

Corneal Ulcer ◽

Disease Index ◽

Eye Drops ◽

Analog Scale ◽

Ocular Surface Disease Index ◽

Corneal Ulcers ◽

Corrected Visual Acuity ◽

The Mean

This study aimed to investigate the use of Plasma Rich in Growth Factors (PRGF) associated with tissue ReGeneraTing Agent (RGTA) drops for the treatment of noninfectious corneal ulcers. RGTA treatment was applied (one drop every two days); however, if ulcer closure was not achieved, PRGF eye drops treatment was added (four times/day). The time taken to reach the ulcer closure, the Best Corrected Visual Acuity (BCVA), intraocular pressure (IOP), Visual Analog Scale (VAS, in terms of frequency and severity of symptoms), and Ocular Surface Disease Index (OSDI) were evaluated. Seventy-four patients (79 eyes) were included, and the mean age was 56.8 ± 17.3 years. The neurotrophic corneal ulcer was the most frequent disorder (n = 27, 34.2%), mainly for herpes virus (n = 15, 19.0%). The time of PRGF eye drops treatment associated with the RGTA matrix was 4.2 ± 2.2 (1.5–9.0) months, and the follow-up period was 44.9 ± 31.5 months. The ulcer closure was achieved in 76 eyes (96.2%). BCVA, VAS and OSDI improved from the baseline (p < 0.001), and IOP remained unchanged (p = 0.665). RGTA and PRGF in noninfectious ulcers were effective and could be a therapeutic alternative for this type of corneal disease.

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Treatment of persistent epithelial defects with single-dose autologous serum eye drops

European Journal of Ophthalmology ◽

10.1177/11206721211048372 ◽

2021 ◽

pp. 112067212110483

Author(s):

Selma Özbek-Uzman ◽

Züleyha Yalnız-Akkaya ◽

Evin Şingar Özdemir ◽

Ayşe Burcu

Keyword(s):

Single Dose ◽

Healing Time ◽

Autologous Serum ◽

Eye Drops ◽

Artificial Tears ◽

Duration Of Treatment ◽

The Mean ◽

Preservative Free ◽

Serum Eye Drops

Purpose: We aimed to investigate the efficacy and safety of single-dose autologous serum eye drops (ASEDs) for treatment of persistent corneal epithelial defects (PEDs). Methods: About 34 eyes of 26 patients treated from March 2016 to May 2020 with a single dose of ASEDs for PEDs that did not respond to conventional treatment were retrospectively evaluated. Patient demographics, predisposing factors, size, and duration of the PED, duration of treatment, and dosage of ASEDs, PED healing time, success rate of the ASED treatment, and follow-up time after the onset of ASED treatment were recorded. Autologous serum eye drops (20%) were prepared by diluting the serum with preservative-free artificial tears in single-dose vials. Vials were stored at −20°C and used daily after dissolving. Results: The mean patient age was 47.0 ± 18.5 years, and 13 (50%) of the patients were male. The most common indication for ASEDs was PED after keratoplasty. The mean duration of ASED treatment was 8.5 ± 6.3 months, and mean follow-up time was 22.8 ± 12.2 months. Autologous serum eye drop treatment was effective in 25 (73.5%) eyes and partially effective in 5 (14.7%) eyes. None of the eyes displayed complications related to the treatment. Conclusion: In patients with PED for whom conservative treatment is insufficient, ASEDs prepared by dilution with preservative-free artificial tears in single-dose vials and administered based on the daily use principle appear to be effective and safe.

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Transoral Incisionless Fundoplication: Initial Experience in Patients Referred to an Integrated Academic Institution

The American Surgeon ◽

10.1177/000313481107701026 ◽

2011 ◽

Vol 77 (10) ◽

pp. 1386-1389 ◽

Cited By ~ 2

Author(s):

Allan Nguyen ◽

Thomas Vo ◽

Xuan-Mai T. Nguyen ◽

Brian R. Smith ◽

Kevin M. Reavis

Keyword(s):

Gastric Surgery ◽

Late Complications ◽

Initial Experience ◽

Additional Time ◽

Transoral Incisionless Fundoplication ◽

Working Space ◽

Symptom Scores ◽

The Mean ◽

New Treatment

Transoral incisionless fundoplication is a new treatment for patients with gastroesophageal reflux disease. We present our initial experience with 10 patients undergoing this procedure with varying past surgical histories. All procedures were performed under general nasotracheal anesthesia. RAND-36 and Visual Analog Scale symptom scores were collected at pre and postoperative appointments for a mean of 9.2 months. The mean procedure time was 68 minutes. There were no intraoperative or postoperative complications. Patients with prior pancreaticoduodenectomy had observed reduced working space due to prior distal gastrectomy and required additional insufflation due to no pyloric resistance to insufflation of the small bowel. The patient with prior fundoplication required additional time and force for fastener penetration of the resultant scar from the partially disrupted fundoplication. All patients were discharged within 23 hours of the procedure. Throughout the follow-up period, patients reported gradual changes in medication requirements and symptom scores. There were no late complications. Transoral incisionless fundoplication is technically safe in well-selected patients including those with prior esophageal and gastric surgery.

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A Comparison of Loratadine, a New Nonsedating Antihistamine, with Clemastine and Placebo in Patients with Fall Seasonal Allergic Rhinitis

American Journal of Rhinology ◽

10.2500/105065887781693411 ◽

1987 ◽

Vol 1 (3) ◽

pp. 151-154 ◽

Cited By ~ 18

Author(s):

James P. Kemp ◽

Sami L. Bahna ◽

Paul Chervinsky ◽

Gary S. Rachelefsky ◽

James M. Seltzer ◽

...

Keyword(s):

Allergic Rhinitis ◽

Seasonal Allergic Rhinitis ◽

Parallel Study ◽

Double Blind ◽

Daily Diaries ◽

Ocular Symptoms ◽

Symptom Scores ◽

The Mean ◽

Long Acting ◽

To Receive

Loratadine is a new nonsedating long-acting H1-antagonist which has been shown to be effective at various doses in controlling symptoms of spring seasonal allergic rhinitis. In this multicenter, double-blind, parallel study, 313 adolescent and adult patients with moderate to severe, skin-test positive, fall seasonal rhinitis were randomized to receive either loratadine, 10 mg, in the morning and placebo in the evening, clemastine 1 mg. b.i.d., or placebo b.i.d. for 2 weeks. Patients maintained daily diaries of nasal and ocular symptoms and of adverse effects. They were evaluated before and 7 and 14 days after starting treatment. The mean symptom scores on days 7 and 14 showed greater improvement with both loratadine and clemastine treatments than with placebo. The incidence of somnolence in the loratadine group by comparison with the placebo group was not statistically different, whereas clemastine caused significantly more drowsiness than did placebo. We conclude that loratadine, 10 mg, once a day is as effective as clemastine b.i.d. in decreasing the symptoms of fall seasonal rhinitis and the incidence of somnolence with loratadine is not statistically different from that with placebo.

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Treatment of Noninfectious Corneal Disorders With Plasma Rich in Growth Factors and ReGenerating Agent Matrix

10.21203/rs.3.rs-49518/v1 ◽

2020 ◽

Author(s):

Ronald Mauricio Sanchez-Avila ◽

Edmar Uribe-Badillo ◽

Carlos Fernandez-Vega Gonzalez ◽

Francisco Muruzabal ◽

Borja De la Sen Corcuera ◽

...

Keyword(s):

Growth Factors ◽

Adverse Events ◽

Corneal Ulcer ◽

Eye Drops ◽

Ocular Surface Disease Index ◽

Corneal Ulcers ◽

Corrected Visual Acuity ◽

The Mean ◽

Mean Time

Abstract Background: To provide the efficacy and safety of Plasma Rich in Growth Factors (PRGF) associated with tissue ReGeneraTing Agent (RGTA) drops for the treatment of noninfectious corneal ulcers.Methods: This retrospective study included patients from Fernandez-Vega University Institute between 2010 and 2019, with noninfectious corneal ulcers and no response to standard treatments. RGTA treatment was firstly applied (1 drop every two days), but if ulcer closure was not achieved, PRGF eye drops treatment was added (4 times/day). The time to reach the ulcer closure; the Best Corrected Visual Acuity (BCVA), intraocular pressure (IOP), Visual Analog Scale (VAS, in frequency and severity of symptoms), and Ocular Surface Disease Index (OSDI) were evaluated. The presence of adverse events along the follow-up period was also reported. Results: Seventy-four patients (79 eyes) were included in the study, forty-six eyes (62.2%) were women, and the mean age was 56.8 ± 17.3 years. The neurotrophic corneal ulcer was the most frequent disorder found in the patients of the study (n = 27, 34.2%), mainly due to the herpes virus (n = 15, 19.0%). The mean time of PRGF eye drops treatment associated with RGTA matrix was 4.2 ± 2.2 (1.5 -9.0) months, and the follow-up period was 44.9 ± 31.5 months. The ulcer closure was achieved in 76 eyes (96.2%). BCVA, VAS and OSDI improved significantly from the baseline (p<0.001), while IOP remained unchanged (p=0.665). No adverse events were recorded. Conclusions: The use of RGTA and PRGF in noninfectious ulcers was effective and safe, and it could be a therapeutic alternative for this type of corneal diseases.

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COMPARATIVE EVALUATION OF TACROLIMUS 0.03% OINTMENT VS OLOPATADINE 0.2% EYE DROPS IN THE TREATMENT OF VERNAL KERATOCONJUNCTIVITIS

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i1.3251 ◽

2021 ◽

Vol 71 (1) ◽

pp. 34-39

Author(s):

Hassan Sajjad Rathore ◽

Shahzad Saeed ◽

Ahsan Mukhtar ◽

Umar Ijaz ◽

Asad Habib ◽

...

Keyword(s):

Subjective Symptom ◽

Military Hospital ◽

Vernal Keratoconjunctivitis ◽

Eye Drops ◽

Subjective Symptoms ◽

Cross Sectional ◽

Group A ◽

Objective Sign ◽

The Mean ◽

Group B

Objective: To compare the efficacy of tacrolimus 0.03% ointment to olopatadine 0.2% eye drops in the treatment of vernal keratoconjunctivitis. Study Design: Prospective cross-sectional study. Place and Duration of Study: Eye Department Combined Military Hospital Quetta, from Feb to Jul 2019. Methodology: A total of 69 patients with active vernal keratoconjunctivitis (VKC) were included in this study.Thirty six (52.17%) patients were randomized in tacrolimus group and 33 (47.83%) in olopatadine group B.Baseline values of the subjective symptom score (SSS) and the objective sign score (OSS) were noted. Patientswere reviewed on weeks 2, 4, 8 and 12 and the scores at each visit were summed. These scores were used forcomparison between groups. Results: At the start of the study, the mean subjective symptoms score and objective sign score of group A was 9.0 ± 2.04 and 3.93 ± 1.93 respectively, while that of group B was 8.88 ± 2.18 and 4.36 ± 1.90 respectively. At the end of 12-weeks, the mean subjective symptoms score and objective sign score of group A reduced to 0.11 ± 0.32 and 0.08 ± 0.28 respectively, while that of group B reduced to 1.70 ± 0.77 and 0.64 ± 0.55 respectively. Total improvement of scores (as a percentage of baselines) among tacrolimus group was 98.3% and olopatadine group was 83%. Conclusion: Although both 0.03% tacrolimus and 0.2% olopatadine were effective in improving the signs andsymptoms of VKC, 0.03% tacrolimus was significantly superior.

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Vitamin D serum levels in children with vernal keratoconjunctivitis and disease control

International Journal of Immunopathology and Pharmacology ◽

10.1177/2058738419833468 ◽

2019 ◽

Vol 33 ◽

pp. 205873841983346

Author(s):

Daniele Giovanni Ghiglioni ◽

Gaia Bruschi ◽

Sara Gandini ◽

Silvia Osnaghi ◽

Diego Peroni ◽

...

Keyword(s):

Vitamin D ◽

Steroid Therapy ◽

Sun Exposure ◽

Serum Levels ◽

Vernal Keratoconjunctivitis ◽

Eye Drops ◽

Overweight Children ◽

Ocular Symptoms ◽

Significant Difference ◽

Pre Treatment

The aim of this study was to evaluate whether the control of ocular symptoms with cyclosporine or with tacrolimus in eye drops allows to improve sun exposure and therefore serum level of vitamin D (VD; 25OHD), in the more severe forms of vernal keratoconjunctivitis (VKC). Out of 242 children followed for active VKC, 94 were treated with 1% cyclosporine or 0.1% tacrolimus eye drops, while the other 148 with mild VKC did not need to be treated with immunomodulators. VD serum levels were measured in spring and autumn in 71 children. In total, 60 of them were treated with cyclosporine eye drops (first group) and 11 (not responding to cyclosporine therapy previously) with 0.1% tacrolimus eye drops (second group) between March and November 2016. Pre-treatment median values of VD were 23.7 ng/mL in the first group and 23.8 in the second group, and post-treatment values increased up to 32.8 and 32.9 ng/mL, respectively. Before treatment, 33% presented a deficiency (25OHD < 20 ng/mL), and at the end of summer, only 4% were deficient. The overweight children had lower improvement in VD serum levels than children with a body mass index (BMI) lower than 85th percentile. Children in therapy with cyclosporine, but requiring the administration of local steroid therapy during the summer for control of the symptoms, showed a greater improvement in 25OHD serum levels in ng/mL (23–37 ng/mL) than children who did not require steroid therapy (24–35 ng/mL). Furthermore, there was a significant difference in change of 25OHD in children presenting limbal VKC (21–41 ng/mL) versus tarsal VKC (24–35 ng/mL) ( P = 0.04). Our study suggests that ocular treatment carried out with immunomodulator eye drops could allow for an improvement in 25OHD serum levels. In children with active VKC and at risk of 25OHD deficiency, likely due to avoidance of sun exposure, the role of other risk factors (BMI, phototype and treatment) on 25OHD serum levels should be considered.

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Proposal of Measurement Occasions for Unbiased Evaluation of Psychotherapy

Verhaltenstherapie ◽

10.1159/000514541 ◽

2021 ◽

pp. 1-6

Author(s):

Edgar Geissner ◽

Petra Maria Ivert ◽

Manfred Schmitt

Keyword(s):

Single Case ◽

Treatment Evaluation ◽

Time Interval ◽

Short Time Interval ◽

Symptom Scores ◽

The Mean ◽

Therapy Success ◽

Short Time ◽

Simplified Calculation

Studies complementing the assessment of symptoms right before (t1), right after therapy (t2), and at follow-up (t3) with an assessment of symptoms preceding the waiting period without intervention (t0) have revealed substantial t0–t1 changes. We discuss this phenomenon based on our own data and address the following questions: does it make sense to compare symptoms at the beginning of therapy (t1) with symptoms at the end of therapy (t2) or at follow-up (t3)? Or does it make more sense to use t0 instead of t1? We argue for the latter alternative based on the following reasons. (1) Symptom descriptions at t0 are realistic. (2) Expecting therapy success mitigates symptom descriptions at t1. (3) Security signals emitted from the therapy context also mitigate symptoms, especially anxiety, at t1. (4) Regression toward the mean reduces the validity of single occasion assessments. Controlling for regression requires two occasions of measurement with a short time interval at t0 (t01 and t02). It follows from this reasoning that therapy success should be evaluated using the t02–t2 and t02–t3 intervals. Single case evaluations require reliable critical differences. This will be illustrated using a concrete example. The validity of treatment evaluation can be increased via the elimination of non-pathological symptom scores. A simplified calculation of cut-off scores can facilitate applied treatment evaluation. Unspecific t0–t1 changes do not challenge therapy effects according to t1–t2 changes. Rather, they are part of the whole therapy process.

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