Abstract
Purpose
To evaluate the effects of loteprednol etabonate on cornea and tear film in patients with seasonal allergic conjunctivitis by anterior segment optical coherence tomography (OCT).
Methods
The right eyes of 52 subjects with seasonal allergic conjunctivitis were evaluated in the study. Central corneal thickness (CCT), the thicknesses of central corneal epithelium (CET) and central non-epithelial cornea (CnET), and lower and upper tear meniscus areas were measured by spectral-domain OCT and ocular surface disease index (OSDI) were obtained at baseline. After topical use of loteprednol etabonate 0.5% eye drop three times a day for 1 week, the measurements were repeated. Paired T test was used for analysis.
Results
Mean CCT and mean thicknesses of CET and CnET at baseline were 528.19 ± 34.47 µm, 64.10 ± 5.30 µm and 462.84 ± 33.43 µm, respectively, and these were 526.31 ± 33.37 µm, 64.65 ± 4.84 µm and 459.84 ± 32.11 µm after the treatment, respectively. OSDI score was 21.55 ± 4.40 at baseline and 13.13 ± 2.39 after 1 week. The lower and upper tear meniscus areas at baseline were 0.026 ± 0.017 mm2 and 0.017 ± 0.007 mm2, respectively, and they were 0.017 ± 0.009 mm2 and 0.016 ± 0.007 mm2, respectively, after the treatment. There is statistically significant difference between before and after values of CCT, CnET, lower tear meniscus area and OSDI score (p < 0.05).
Conclusion
There is no change in corneal epithelial thickness and upper tear meniscus area after 1-week treatment with loteprednol etabonate in patients with seasonal allergic conjunctivitis, but it may cause decrease in non-epithelial corneal thickness and lower tear meniscus area.
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References
Bartlett JD, Horwitz B, Laibovitz R, Howes JF (1993) Intraocular pressure response to loteprednol etabonate in known steroid responders. J Ocul Pharmacol 9:157–165. https://doi.org/10.1089/jop.1993.9.157
Jobling AI, Augusteyn RC (2002) What causes steroid cataracts? A review of steroid-induced posterior subcapsular cataracts. Clin Exp Optom 85:61–75. https://doi.org/10.1111/j.1444-0938.2002.tb03011.x
Holland EJ, Fingeret M, Mah FS (2019) Use of topical steroids in conjunctivitis: a review of the evidence. Cornea 38:1062–1067. https://doi.org/10.1097/ico.000000000000198200003226-201908000-00026
Sheppard JD, Comstock TL, Cavet ME (2016) Impact of the topical ophthalmic corticosteroid loteprednol etabonate on intraocular pressure. Adv Ther 33:532–552. https://doi.org/10.1007/s12325-016-0315-810.1007/s12325-016-0315-8
Leonardi A (2002) The central role of conjunctival mast cells in the pathogenesis of ocular allergy. Curr Allergy Asthma Rep 2:325–331. https://doi.org/10.1007/s11882-002-0061-7
Kumagai N, Yamamoto K, Fukuda K, Nakamura Y, Fujitsu Y, Nuno Y, Nishida T (2002) Active matrix metalloproteinases in the tear fluid of individuals with vernal keratoconjunctivitis. J Allergy Clin Immunol 110:489–491. https://doi.org/10.1067/mai.2002.126379
Pekel G, Firinci F, Acer S, Kasikci S, Yagci R, Mete E, Cetin EN (2016) Optical densitometric measurements of the cornea and lens in children with allergic rhinoconjunctivitis. Clin Exp Optom 99:51–55. https://doi.org/10.1111/cxo.12322
Friedlaender MH, Howes J (1997) A double-masked, placebo-controlled evaluation of the efficacy and safety of loteprednol etabonate in the treatment of giant papillary conjunctivitis. The loteprednol etabonate giant papillary Conjunctivitis Study Group I. Am J Ophthalmol 123:455–464. https://doi.org/10.1016/s0002-9394(14)70171-0
Lee H, Chung B, Kim KS, Seo KY, Choi BJ, Kim TI (2014) Effects of topical loteprednol etabonate on tear cytokines and clinical outcomes in moderate and severe meibomian gland dysfunction: randomized clinical trial. Am J Ophthalmol 158:1172–1183. https://doi.org/10.1016/j.ajo.2014.08.015s0002-9394(14)00496-6
Liu RF, Wu XX, Wang X, Gao J, Zhou J, Zhao Q (2017) Efficacy of olopatadine hydrochloride 0.1%, emedastine difumarate 0.05%, and loteprednol etabonate 0.5% for Chinese children with seasonal allergic conjunctivitis: a randomized vehicle-controlled study. Int Forum Allergy Rhinol 7:393–398. https://doi.org/10.1002/alr.21882
Doguizi S, Sekeroglu MA, Inanc M, Yilmazbas P (2019) Evaluation of tear meniscus dimensions using anterior segment optical coherence tomography in video terminal display workers. Clin Exp Optom 102:478–484. https://doi.org/10.1111/cxo.12872
Uzunosmanoglu E, Mocan MC, Kocabeyoglu S, Karakaya J, Irkec M (2016) Meibomian gland dysfunction in patients receiving long-term glaucoma medications. Cornea 35:1112–1116. https://doi.org/10.1097/ICO.0000000000000838
Gumus K, Crockett CH, Pflugfelder SC (2010) Anterior segment optical coherence tomography: a diagnostic instrument for conjunctivochalasis. Am J Ophthalmol 150:798–806. https://doi.org/10.1016/j.ajo.2010.06.014s0002-9394(10)00440-x
Ma XJ, Wang L, Koch DD (2013) Repeatability of corneal epithelial thickness measurements using Fourier-domain optical coherence tomography in normal and post-LASIK eyes. Cornea 32:1544–1548. https://doi.org/10.1097/ICO.0b013e3182a7f39d
Ma JX, Wang L, Weikert MP, Montes de Oca I, Koch DD (2019) Evaluation of the repeatability and reproducibility of corneal epithelial thickness mapping for a 9-mm zone using optical coherence tomography. Cornea 38:67–73. https://doi.org/10.1097/ICO.0000000000001806
Chen S, Huang J, Wen D, Chen W, Huang D, Wang Q (2012) Measurement of central corneal thickness by high-resolution Scheimpflug imaging, Fourier-domain optical coherence tomography and ultrasound pachymetry. Acta Ophthalmol 90:449–455. https://doi.org/10.1111/j.1755-3768.2010.01947.xaos1947
Wang X, Dong J, Wu Q (2015) Corneal thickness, epithelial thickness and axial length differences in normal and high myopia. BMC Ophthalmol 15:49. https://doi.org/10.1186/s12886-015-0039-610.1186/s12886-015-0039-6
Stahn C, Lowenberg M, Hommes DW, Buttgereit F (2007) Molecular mechanisms of glucocorticoid action and selective glucocorticoid receptor agonists. Mol Cell Endocrinol 275:71–78. https://doi.org/10.1016/j.mce.2007.05.019
Villani E, Rabbiolo G, Nucci P (2018) Ocular allergy as a risk factor for dry eye in adults and children. Curr Opin Allergy Clin Immunol 18:398–403. https://doi.org/10.1097/ACI.0000000000000471
Hatou S, Yamada M, Mochizuki H, Shiraishi A, Joko T, Nishida T (2009) The effects of dexamethasone on the Na, K-ATPase activity and pump function of corneal endothelial cells. Curr Eye Res 34:347–354. https://doi.org/10.1080/02713680902829624910773411
Saarni H, Hopsu-Havu VK (1978) The decrease of hyaluronate synthesis by anti-inflammatory steroids in vitro. Br J Dermatol 98:445–449. https://doi.org/10.1111/j.1365-2133.1978.tb06539.x
Mapleson JL, Buchwald M (1981) Effect of cycloheximide and dexamethasone phosphate on hyaluronic acid synthesis and secretion in cultured human skin fibroblasts. J Cell Physiol 109:215–222. https://doi.org/10.1002/jcp.1041090204
Laurent UB (1983) Reduction of the hyaluronate concentration in rabbit aqueous humour by topical prednisolone. Acta Ophthalmol (Copenh) 61:751–755. https://doi.org/10.1111/j.1755-3768.1983.tb01456.x
Weber BA, Gan L, Fagerholm PP (2001) Short-term impact of corticosteroids on hyaluronan and epithelial hyperplasia in the rabbit cornea after photorefractive keratectomy. Cornea 20:321–324. https://doi.org/10.1097/00003226-200104000-00016
Kosina-Hagyo K, Veres A, Fodor E, Mezei G, Csakany B, Nemeth J (2012) Tear film function in patients with seasonal allergic conjunctivitis outside the pollen season. Int Arch Allergy Immunol 157:81–88. https://doi.org/10.1159/000324657000324657
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Yeter, V., Koçak, N. & Eser-Ozturk, H. Changes in corneal thickness, upper and lower tear film in seasonal allergic conjunctivitis by steroid treatment: anterior segment optical coherence tomography study. Int Ophthalmol 40, 2275–2281 (2020). https://doi.org/10.1007/s10792-020-01410-8
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DOI: https://doi.org/10.1007/s10792-020-01410-8