Ocular-Hypertensive and Anti-inflammatory Response to Rimexolone Therapy in Children

Abstract

Objective: To compare the ocular-hypertensive and antiinflammatory response to rimexolone (116-hydroxy-16␣fluoro-6␣methylpresdnisolone) and fluorometholone (21-deoxy-9␣fluoro-6␣methylprednisolone) therapy in children's eyes.Methods: With parental consent, children who underwent surgical procedures for bilateral symmetric strabismus from January 18, 2000, through November 16, 2001, were recruited. One eye was randomized to receive topical 1% rimexolone while the contralateral eye received topical 0.1% fluorometholone, 4 times daily for 4 weeks. Main Outcome Measures: Intraocular pressures and anti-inflammatory responses were the main outcome measures and were serially measured postoperatively for 8 weeks. Results: Fifty-four children, aged from 4 to 8 years (mean [SD] age, 5.33 [1.26] years), participated in the (REPRINTED) ARCH OPHTHALMOL / VOL 121, DEC 2003 WWW.ARCHOPHTHALMOL.COM 1716

Evidence-based, interdisciplinary guidelines for anti-inflammatory treatment of uveitis associated with juvenile idiopathic arthritis

“…After 4-6 weeks, the patient can be switched to less effective drugs (hence, drugs causing fewer adverse effects: e.g., rimexolone) [35,45,46] (IA). In individual cases, the lesser efficacy of the anti-inflammatory preparations needs to be weighed against the problems associated with more frequent application and compliance.…”

“…Rimexolone may be effective in cases of steroid-induced ocular hypertension, but compared to prednisolone acetate 1% and dexamethasone 0.1%, it shows a lower antiinflammatory effect [35,45] (IA). Table 8 Evidence-based, interdisciplinary guidelines for anti-inflammatory treatment of uveitis associated with juvenile idiopathic arthritis (Key statements)…”

Rimexolone 1% versus prednisolone acetate in preventing early postoperative inflammation after cataract surgery

“…In two other studies, one reported that rimexolone was as effective as prednisolone after phacoemulsification surgery and the other reported that both have the same efficacy in controlling inflammation in patients with anterior uveitis [16]. Fan et al reported that the ocular pressure-increasing effect of rimexolone is much more prominent in children with postoperative inflammation than in adult patients [13]. The period of our study was not long enough to evaluate the pressure-increasing effect of both medications.…”

“…This is particularly true for steroids that have a predilection for elevating IOP. Corticosteroids, on the other hand, reduce short term complications such as high intra-ocular pressure, photophobia, pain, and low visual acuity [2,10,[12][13][14].…”

Intraocular pressure elevation in uveitis

“…Fluoromethalone alcohol 0.1% causes an IOP elevation between 2.6 and 5.8 mmHg, with the peak IOP being between 17.1 and 20.6 mmHg after a mean duration of 6-15 days in children [30][31][32]. Its IOP-elevating potential is also low in adults who are known to be steroid responders and comparable to that of rimexolone 1.0% [33].…”