Chen Minjie, Ke Bilian, Zou Jun, Gong Lan, Wang Yan, Zhang Chaoran, Xu Jianjiang, Wei Anji, Hong Jiaxu
Department of Ophthalmology, Eye and Ear, Nose, Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China.
Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, 83 Fenyang Road, Shanghai 200031, China.
J Clin Med. 2022 Jul 4;11(13):3877. doi: 10.3390/jcm11133877.
This study sought to evaluate the efficacy of the isolated use of fluorometholone compared with the combined use of azelastine and fluorometholone for the treatment of severe allergic conjunctival disease (ACD). One hundred and eleven patients with severe ACD were randomized into two groups: one treated with topical 0.1% fluorometholone combined with 0.05% azelastine and the other with 0.1% fluorometholone alone. The Ocular Surface Disease Index (OSDI) and the signs of keratopathy, palpebral conjunctiva papillae and conjunctival congestion were scored before and at one, two and six weeks after treatment and compared between the groups. The intra-ocular pressure (IOP) was also monitored. There were no significant differences between the groups in the baseline mean scores of signs and OSDI scores, which gradually improved at all visits after therapy in both groups. Although the time effect was significant for all the parameters (all p < 0.001), the reduction in corneal involvement scores from week 2 to week 6 was insignificant in both groups (p = 0.460 for the steroids group and p = 0.074 for the combination group). All signs and symptoms were significantly more improved in the combination group than in the isolated group at each control visit. IOP remained stable at all visits (all p < 0.001), except one patient in each group had elevated IOP over 21 mmHg. While both the isolated use of fluorometholone and combined use of azelastine and fluorometholone are effective in alleviating the signs and symptoms of severe ACD, optimal response can be achieved with adjunctive treatment including azelastine.
本研究旨在评估单独使用氟米龙与联合使用氮卓斯汀和氟米龙治疗重度过敏性结膜炎（ACD）的疗效。111例重度ACD患者被随机分为两组：一组接受局部用0.1%氟米龙联合0.05%氮卓斯汀治疗，另一组仅接受0.1%氟米龙治疗。在治疗前以及治疗后1周、2周和6周对眼表疾病指数（OSDI）、角膜病变体征、睑结膜乳头和结膜充血情况进行评分，并在两组之间进行比较。同时监测眼压（IOP）。两组在体征和OSDI评分的基线平均得分方面无显著差异，两组在治疗后的所有随访中这些指标均逐渐改善。虽然所有参数的时间效应均显著（所有p<0.001），但两组从第2周到第6周角膜受累评分的降低均不显著（类固醇组p = 0.460，联合组p = 0.074）。在每次对照访视时，联合组的所有体征和症状改善均显著优于单独用药组。除每组各有1例患者眼压升高超过21 mmHg外，所有访视时眼压均保持稳定（所有p<0.001）。虽然单独使用氟米龙以及联合使用氮卓斯汀和氟米龙均可有效缓解重度ACD的体征和症状，但联合使用氮卓斯汀等辅助治疗可获得最佳疗效。
