Conjunctivitis Research Today is a free monthly online journal that collates and summarizes the latest research about Conjunctivitis, including details on pink eye, symptoms, causes, treatment, medication.

Treatment of ocular inflammatory conditions with loteprednol etabonate.

Pavesio CE, Decory HH

Moorfields Eye Hospital, London EC1V 2PD, UK. carlos.pavesio@moorfields.nhs.uk

Ocular inflammatory diseases impose a significant medical and economic burden on society. Corticosteroids are potent anti-inflammatory agents that have been used successfully to treat ocular inflammation. Topical corticosteroids provide maximal drug delivery, and are used to reduce the signs and symptoms of intraocular and ocular surface inflammation. However, side effects associated with topical corticosteroids-including increased intraocular pressure, risk of cataract formation after long-term use, and decreased resistance to infection-are concerns. Loteprednol etabonate (LE) is an ester corticosteroid with a high therapeutic index that contains an ester, rather than a ketone, at carbon-20 of the prednisolone core structure. LE blocks the release and action of inflammatory mediators and is clinically effective in the treatment of steroid-responsive inflammatory conditions including giant papillary conjunctivitis, seasonal (intermittent) allergic conjunctivitis and uveitis. LE relieves ocular surface and lacrimal gland inflammation associated with dry eye and is used in combination with ciclosporin A as a treatment of dry eye. LE is also effective in the treatment of postoperative ocular inflammation. Because of its rapid de-esterification to inactive metabolites, LE appears to have an improved safety profile compared with ketone corticosteroids, and may be more suitable than ketone corticosteroids for the treatment for ocular inflammatory conditions in which long-term therapy is necessary. However, further comparative safety studies are needed.

Published 28 March 2008 in Br J Ophthalmol, 92(4): 455-9.
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Articles on Conjunctivitis published 25 March 2008:

Elevated expression and activation of matrix metalloproteinase 8 in tear fluid in atopic blepharoconjunctivitis.   Cornea, 27(3): 297-301.

PURPOSE: Matrix metalloproteinase 8 (MMP-8) is an effective collagenolytic enzyme that is associated with many ocular inflammatory diseases, such as uveitis, keratitis, and ocular rosacea. We studied the tear fluid concentration and activation of MMP-8 in atopic blepharoconjunctivitis (ABC) and the presence of the enzyme in conjunctival inflammatory cells in vivo. METHODS: Tear fluid samples were collected from 26 patients with ABC and 26 healthy controls. MMP-8 concentrations were determined ... [Abstract] [Full-text]

Clinical course of epidemic keratoconjunctivitis: evaluation by in vivo confocal microscopy.   Cornea, 27(3): 263-8.

PURPOSE: To describe, by in vivo confocal microscopy, the structural changes occurring during the course of adenovirus epidemic keratoconjunctivitis (EKC), from the onset of the disease up to 24 weeks of follow-up. METHODS: Eight patients (age, 8-57 years) with clinical evidence of EKC were examined and photographed in vivo with a Heidelberg Retina Tomograph II, Rostock Cornea Module. RESULTS: At 1 week, confocal microscopy revealed clusters of hyperreflective cells in the basal epithelial cell ... [Abstract] [Full-text]

Articles on Conjunctivitis published 27 February 2008:

Phlyctenular keratoconjunctivitis in a patient with Staphylococcal blepharitis and ocular rosacea.   Optometry, 79(3): 133-7.

BACKGROUND: Phlyctenular keratoconjunctivitis is a type IV hypersensitivity reaction to an inciting agent. The presentation is usually bilateral. The diagnosis can be difficult, especially if compounded by an underlying skin disorder such as rosacea. The 2 types of phlyctenules are differentiated based on the location on the eye, i.e., conjunctival or corneal. CASE REPORT: A 22-year-old man presented with painful, bilateral, elevated vascularized corneal lesions. Ultimately, the diagnosis was ... [Abstract] [Full-text]

Articles on Conjunctivitis published 20 February 2008:

Comparison of annual and biannual mass antibiotic administration for elimination of infectious trachoma.   JAMA, 299(7): 778-84.

CONTEXT: Treatment recommendations assume that repeated mass antibiotic distributions can control, but not eradicate or even locally eliminate, the ocular strains of chlamydia that cause trachoma. Elimination may be an important end point because of concern that infection will return to communities that have lost immunity to chlamydia after antibiotics are discontinued. OBJECTIVE: To determine whether biannual treatment can eliminate ocular chlamydial infection from preschool children and to ... [Abstract] [Full-text]

Articles on Conjunctivitis published 19 February 2008:

Conjunctival resection combined with tenon layer excision and the involvement of mast cells in superior limbic keratoconjunctivitis.   Am J Ophthalmol, 145(3): 445-452.

PURPOSE: To evaluate the effectiveness of conjunctival resection combined with Tenon layer excision in treating superior limbic keratoconjunctivitis (SLK) and the involvement of mast cells in SLK. DESIGN: Retrospective, interventional case series. METHODS: Forty eyes of 30 SLK patients who were unresponsive to medical treatment received superior bulbar conjunctival resection, and another 20 patients who underwent cataract and retinal surgery served as a control group. The conjunctiva specimens ... [Abstract] [Full-text]

Articles on Conjunctivitis published 13 February 2008:

Quality of life in rhinoconjunctivitis assessed with generic and disease-specific questionnaires.   Allergy, 63(3): 284-91.

BACKGROUND: Illness as perceived by the allergic patient with asthma and/or rhinoconjunctivitis (RC) can be assessed by measurements of their health-related quality of life (HRQL). For this purpose the RC Quality of Life Questionnaire (RQLQ) has gained general acceptance; however, as most allergic patients experience symptoms from multiple organs, disease-specific HRQL measures may be deficient. This study compares a generic and a disease-specific HRQL instrument in grass and/or mite-allergic ... [Abstract] [Full-text]

Articles on Conjunctivitis published 8 February 2008:

Evaluation of the effects of olopatadine ophthalmic solution, 0.2% on the ocular surface of patients with allergic conjunctivitis and dry eye.   Curr Med Res Opin, 24(2): 441-7.

PURPOSE: Olopatadine hydrochloride 0.2% (Pataday, Alcon, Fort Worth, USA) is a topical ocular anti-allergic agent that has shown high rates of efficacy in treating ocular itching, the primary symptom of allergic conjunctivitis, and allows for once-daily dosing. Since some patients suffer from signs or symptoms of dry eye in addition to ocular allergy, this study was designed to evaluate the safety of olopatadine 0.2% in a population of patients with both allergic conjunctivitis and dry eye. ... [Abstract] [Full-text]

Articles on Conjunctivitis published 4 February 2008:

Chlamydia trachomatis as a cause of neonatal conjunctivitis in Dutch infants.   Pediatrics, 121(2): e321-6.

BACKGROUND: Chlamydia trachomatis is the most common sexually transmitted pathogen in adults, which at delivery may be transmitted from mother to child and cause conjunctivitis and pneumonia. In The Netherlands, prenatal chlamydial screening and treatment of pregnant women is not routine practice. The contribution of C. trachomatis to neonatal ophthalmic disease has not been studied in The Netherlands and remains unclear. METHODS: At the Sophia Children's Hospital and Rotterdam Eye Hospital, 2 ... [Abstract] [Full-text]

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