Abstract
Giant Papillary Conjunctivitis (GPC) is a conjunctival inflammatory condition associated with contact lens wear. The etiology is still unknown and no adequate treatment is found. Mastcell stabilizing drugs are useful in the treatment of chronic inflammatory processes. The effect of 6% N-acetyl-aspartyl glutamic acid (NAAGA), a mastcell stabilizing agent, in a double-masked comparative trial with placebo in the treatment of GPC is reported.
Seventeen patients with symptomatic GPC were treated over a four week period, eyes were randomized to receive NAAGA or placebo. A decrease in symptoms was found for both eyes. No significant difference of clinical symptoms and signs were observed between NAAGA or placebo treated eyes. These results suggest a wash effect of placebo in GPC. Tear C3a showed a increased level compared to normals but no statistically significance was observed in our study. The results of this study indicate that mastcell stabilization in GPC has little effect and treatment should be focused more on inflammatory mediators released because of mechanical stimuli.
Similar content being viewed by others
References
Spring TF, Reaction to hydrophillic lenses. Med J Aust 1974; 449–50
Korb DR, Allansmith MR, Greiner JV. Prevalence of conjunctival changes in wearers of hard contactlenses. Am J Ophthalmol 1978; 185: 250–59.
Friedlaender FH. Current concepts in occular allergy. Annals of Allergy 1991; 67: 5–13.
Allansmith MR, Korb DR, Grenier JV. Giant papillary conjunctivitis in contact lens wearers. Am J Ophthalmol, 1977; 83: 697–708.
Meisler DM, Berzins UJ, Krachmer JH, Stock EL. Cromolyn treatment of Giant Papillary Conjunctivitis. Arch Ophthalmol 1982; 100: 1608–10.
van Bijsterveld OP, Aalders Deenstra V. Clinical trial of NAAGA eyedrops in sub-acute and chronic atopic conjunctivitis Klin Mbl Augenheilk 1986; 188: 625–27.
Goldschmidt PL, Vulliez-Le Normand B, Briquet I, Dray F. Effects of N-acetyl-aspartyl glutamic acid and sodium cromoglycate on leukotriene B4 secretion by human leukoctyes. Allergy 1990; 45: 363–69.
Etievant M, Leluc B, David B. In vitro inhibition of the classical and alternate pathways of activation of human complement by N acetyl aspartyl glutamic acid (NAAGA). Agents and Actions 1988; 24: 137–44.
Ballow M, Donshik PC, Mendelson L. Complement proteins and C3 anaphylatoxin in the tears of patients with conjunctivitis. J Allergy Clin Immun 1985; 76: 734–76.
van Agtmaal EJ, van Haeringen NJ, Bloem MW, Schreurs WHP, Saowakontha S. Recovery of proteins from tear fluid stored in cellulose sponges. Curr Eye Res 1987; 6: 585–88.
van de Graaf EA, Jansen HM, Bakker MM, Alberts C, Eeftinck Schattenkerk JKM, Out TA. ELISA of complement C3a in bronchoalveolair lavage fluid. J Immun Meth 1992; 147: 241–50.
Matter M, Rahi AHS, Buckley RJ. Sodium cromoglycate in the treatment of contact lens-associated giant papillary conjunctivitis. Proc VII Congress of Europ Soc Ophthalmol, Helsinki, 1985; 383–84.
Leino M, Ennevaar K, Latvala A-L, Nordgren P, Posti AM, Suves R. Double blind comparative study of 2% nedocromil eye drops with 2% sodium cromoglycate and placebo eye drops in the treatment of seasonal allergic conjunctivitis. Clin Exp Allergy 1992; 22: 929–32.
Azvedo M, Castel-Branco MG, Ferraz Oliveira J, Ramos E, Delgado L, Almeida J. Double-blind comparison of levocabastine eye drops with sodium cromoglycate and placebo in the treatment of seasonal allergic conjunctivitis. Clin Exp Allergy 1991; 21: 689–94.
Sack RA, Tan KO, Tan A. Diurnal tear cycle: Evidence for a nocturnal inflammatory constitutive tear fluid. Invest Ophthalmol Vis Sci 1992; 33: 626–40.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Meijer, F., Pogany, K., Kok, J.H.C. et al. N-acetyl-aspartyl glutamic acid (NAAGA) topical eyedrops in the treatment of Giant Papillary Conjunctivitis (GPC). Doc Ophthalmol 85, 5–11 (1993). https://doi.org/10.1007/BF01268095
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01268095