Nathan H, Naveh N, Meyer E
Department of Ophthalmology, Rambam Medical Center, Haifa, Israel.
Doc Ophthalmol. 1994;85(3):247-57. doi: 10.1007/BF01664932.
A therapeutic trial of 1% indomethacin (Indoptic) eye drops was carried out in 21 children. Looking for possible mediators of inflammation in vernal conjunctivitis, prostaglandin E2 (PGE2) and leukotriene B4 (LTB4 levels in the tears of 9 patients were measured and the effect of the treatment on them examined. A control group of 10 unaffected children was added. Out of 42 eyes in which indomethacin treatment was instilled, only 17 remained in treatment through a 6-week follow-up period. In a few of them a moderate improvement was obtained. The mean level of PGE2 in the patients before treatment was found to be slightly lower than that in the control group, and it dropped even lower during treatment. The average LTB4 level found in patients before treatment was significantly higher than the control group; it decreased somewhat following treatment, but not significantly. This is the first report of elevated LTB4 levels in vernal conjunctivitis, previously not recorded in the literature, it points to the possible role of LTB4 in the pathogenesis of the disease. A constant relationship was observed between low PGE2 levels and high LTB4 content in the patients' tears during highly inflamed states of the eye. We conclude that: (a) indomethacin did not prove to be a highly effective topical treatment for vernal conjunctivitis; (b) PGE2 does not seem to be a dominant mediator of inflammation in this disease; and (c) LTB4, on the other hand, apparently has a role in the mechanism of inflammation of the disease, thus raising hopes for future addition to therapy.
对21名儿童进行了1%吲哚美辛（吲哚美辛眼药水）眼药水的治疗试验。为了寻找春季结膜炎炎症的可能介质，测量了9名患者泪液中前列腺素E2（PGE2）和白三烯B4（LTB4）的水平，并检查了治疗对它们的影响。增加了10名未受影响儿童作为对照组。在42只接受吲哚美辛治疗的眼睛中，只有17只在为期6周的随访期内仍在接受治疗。其中少数眼睛有中度改善。发现患者治疗前PGE2的平均水平略低于对照组，治疗期间甚至更低。患者治疗前LTB4的平均水平显著高于对照组；治疗后有所下降，但不显著。这是首次报道春季结膜炎中LTB4水平升高，此前文献中未记录，这表明LTB4在该疾病发病机制中可能起作用。在眼部高度炎症状态下，观察到患者泪液中低PGE2水平与高LTB4含量之间存在恒定关系。我们得出以下结论：（a）吲哚美辛并未被证明是治疗春季结膜炎的高效局部治疗方法；（b）PGE2似乎不是该疾病炎症的主要介质；（c）另一方面，LTB4显然在该疾病的炎症机制中起作用，因此为未来的治疗增添了希望。
