Preservative-free diclofenac sodium 0.1% for vernal keratoconjunctivitis

D'Angelo, Gennaro; Lambìase, Alessandro; Cortês, M.M.M.; Sgrulletta, Roberto; Pasqualetti, Roberta; Lamagna, Ambra; Bombardieri, Stefano

doi:10.1007/s00417-002-0612-6

Cited by 36 publications

(28 citation statements)

References 19 publications

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“…In a prospective, open study, preservativefree diclofenac (0.1%) eyedrops reduced the symptoms of VKC through the inhibition of prostaglandin production in 40% of patients. Although the conjunctival hyperemia was reduced significantly, the papillary size and corneal lesions remained unchanged [21].…”

Section: Nsaidsmentioning

confidence: 98%

Modern Approach to Managing Vernal Keratoconjunctivitis

Kumar

Gupta

Vivian

2010

Curr Allergy Asthma Rep

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Vernal keratoconjunctivitis (VKC), an allergic inflammation of the conjunctiva affecting mainly children and adolescents, is categorized under the rubric of allergic conjunctivitis. Lack of uniform diagnostic and predefined staging criteria has been a bottleneck in formulating fixed guidelines to treat VKC. This lack of consensus among clinicians/researchers regarding diagnostic and grading standards has prevented us from making comparisons between the outcomes of different studies. To treat VKC, selection of a drug from many available options should be based on the duration and frequency of symptoms, grade and inflammation of giant papillae, and severity of corneal involvement. Consideration also should be given to the patient's specific needs. The basic tenet of treatment is optimal control of symptoms with a minimum of toxic side effects resulting from prolonged use of medication.

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Section: Nsaidsmentioning

confidence: 98%

Modern Approach to Managing Vernal Keratoconjunctivitis

Kumar

Gupta

Vivian

2010

Curr Allergy Asthma Rep

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“…Nonsteroidal anti-inflammatory agents also produce a beneficial effect on the course of VKC. 55 Topical steroid preparations are, naturally, the most effective therapy for moderate to severe form of VKC, 5,9 however their use should be strictly limited and carefully monitored because long-term use of topical steroids is responsible for the 2% incidence of glaucoma in VKC patients. 5 Therefore, this class of drugs should be used to restore corneal damage induced by epithelial toxic mediators from eosinophils and neutrophils.…”

Section: Therapymentioning

confidence: 99%

Vernal keratoconjunctivitis

Bombardieri

Coassin

Aronni

et al. 2004

Eye

248

244

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Vernal keratoconjunctivitis (VKC) is an allergic eye disease that especially affects young boys. The most common symptoms are itching, photophobia, burning, and tearing. The most common signs are giant papillae, superficial keratitis, and conjunctival hyperaemia.Patients with VKC frequently have a family or medical history of atopic diseases, such as asthma, rhinitis, and eczema. However, VKC is not associated with a positive skin test or RAST in 42-47% of patients, confirming that it is not solely an IgE-mediated disease. On the basis of challenge studies as well as immunohistochemical and mediator studies, a Th2-driven mechanism with the involvement of mast cells, eosinophils, and lymphocytes has been suggested. Th2 lymphocytes are responsible for both hyperproduction of IgE (interleukin 4, IL-4) and for differentiation and activation of mast cells (IL-3) and eosinophils . Other studies have demonstrated the involvement of neural factors such as substance P and NGF in the pathogenesis of VKC, and the overexpression of oestrogen and progesterone receptors in the conjunctiva of VKC patients has introduced the possible involvement of sex hormones. Thus, the pathogenesis of VKC is probably multifactorial, with the interaction of the immune, nervous, and endocrine systems.The clinical management of VKC requires a swift diagnosis, correct therapy, and evaluation of the prognosis. The diagnosis is generally based on the signs and symptoms of the disease, but in difficult cases can be aided by conjunctival scraping, demonstrating the presence of infiltrating eosinophils. Therapeutic options are many, in most cases topical, and should be chosen on the basis of the severity of the disease. The most effective drugs, steroids, should however be carefully administered, and only for brief periods, to avoid secondary development of glaucoma.A 2% solution of cyclosporine in olive oil or in castor oil should be considered as an alternative. The long-term prognosis of patients is generally good; however 6% of patients develop corneal damage, cataract, or glaucoma.

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“…Based on these interesting pharmacological features of NSAID in topical use, combined long-term local application of NSAID eye drops with corticosteroid and mast cell-stabilizing eye drops has potential for the treatment and control of VKC. Although it has been reported that ketrolac 0.5% [18], indomethacin [12] and diclofenac [19] eye drops are effective in controlling VKC, no study has been carried out with an observation longer than 1 year with concomitant use of corticosteroid and anti-allergic eye drops.…”

Section: Introductionmentioning

confidence: 99%

Topical Bromfenac Sodium for Long-Term Management of Vernal Keratoconjunctivitis

Uchio

Itoh²,

Kadonosono³

2007

Ophthalmologica

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Background/Aims: We evaluated the efficacy and safety of long-term management of patients with vernal keratoconjunctivitis (VKC) with bromfenac sodium eye drops in combination with corticosteroids and anti-allergic eye drops. Methods: Twenty-two patients with VKC were randomly assigned to receive two test eye drops, either bromfenac sodium 0.1% (group A) or placebo eye drops (normal saline; group B) for a mean observation period of 20.9 months. Topical corticosteroids and mast cell stabilizers were continued during the observation period. Results: The mean 2-year recurrence rate was 90.9% in group A and 11.3% in group B, with a significant difference. No serious side effect was observed in group A. Conclusion: These results suggest that bromfenac sodium eye drops can be used as baseline local treatment in patients with VKC.

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Preservative-free diclofenac sodium 0.1% for vernal keratoconjunctivitis

Abstract: VKC is a chronic disease that requires prolonged treatment to control the inflammatory process. Our preliminary study demonstrates the efficacy and safety of preservative-free diclofenac sodium 0.1% eye drops in controlling the signs and symptoms of VKC in prolonged treatment.

Cited by 36 publications

References 19 publications

Modern Approach to Managing Vernal Keratoconjunctivitis

Modern Approach to Managing Vernal Keratoconjunctivitis

Vernal keratoconjunctivitis

Topical Bromfenac Sodium for Long-Term Management of Vernal Keratoconjunctivitis

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