Allerjik Konjonktivitte Topikal A Vitaminin Etkinliği- Olgu Kontrol Araştırması

Year 2024, Volume: 16 Issue: 3, 74 - 80, 31.12.2024

Hakika Erdogan , Ziya Akingöl , Kardelen Taş

https://doi.org/10.35514/mtd.2024.115

Abstract

Amaç:Bu çalışmanın amacı semptomatik alerjik konjonktivit ve kuru göz hastalarının konforu üzerine topikal A vitamini merheminin (retinol palmitat, 250 IU/g) etkinliğini değerlendirmektir.
Tasarım: Retrospektif çalışma
Katılımcılar ve Yöntemler:Bu çalışmaya mevsimsel ve perennial alerjik konjonktivitli 93 hasta dahil edildi. 47 hastaya topikal A vitamini merhemi ve klasik oküler alerji tedavisi, 46 hastaya ise sadece klasik oküler alerji tedavisi (kontrol grubu) reçete edildi. Hastaların oküler alerji ve kuru göz belirtileri ve semptomları her grupta tedavi öncesi ve sonrası karşılaştırıldı.
Sonuçlar:Topikal A vitamini tedavisi ve kontrol grupları, oküler yüzey hastalığı indeksi (OSDI) skorları ve parçalanma zamanı (BUT) değerleri açısından oküler muayenede anlamlı iyileşmeye yol açtı, ancak sonuçlar A vitamini grubunda karşılaştırmalı olarak daha iyiydi. Kornea yüzey durumu için Oxford şemasının sonuçlarını gözlemledik ve oküler alerjinin ana semptomları ve diğer bulguları, gruplar arasında anlamlı bir fark olmaksızın, tedaviden sonra her iki grupta da düzeldi.
Sonuçlar:Bulgularımız, topikal A vitamini ile yapılan ek tedavinin kuru göz semptomlarının eşlik ettiği alerjik konjonktivit için etkili olduğunu göstermektedir.

Keywords

allerjik konjonktivit, topikal A vitamini, Kuru göz, OSDI, BUT, Oxford

Project Number

2017/900/93

The Efficacy of Topical Vitamin A In Allergic Conjunctivitis - Case Control Research

Abstract

Objective:
The aim of this study is to evaluate the efficacy of topical vitamin A ointment (retinol palmitate, 250 IU/g) on the comfort of for the patients with symptomatic allergic conjunctivitis and dry eye.
Design: Retrospective study
Participants and Methods:
93patients with seasonal and perennial allergic conjunctivitis were enrolled in this study. We prescribed topical vitamin A ointment and the classic ocular allergy treatment to 47 and classic ocular allergy treatment only to 46 (control group) patients, respectively. Patients’ ocular allergy and dry eye signs and symptomswere compared before and after the treatment in each group.
Results:
The topical vitamin A treatment and control groups led to significant improvement in the ocular examination in terms of ocular surface disease index (OSDI) scores and breakup time (BUT) values, but the results were comparatively better in the vitamin A group. We observed the results of the Oxford scheme for the corneal surface condition, and the main symptoms and the other findings of ocular allergy had improved in both the groups after the treatment, without significant differences between the groups.

Conclusions:
Our findings suggest that the adjunct treatment with topical vitamin A is effective for allergic conjunctivitis accompanied by dry eye symptoms.

Keywords

allergic conjunctivitis, topical vitamin A, dry eye, OSDI, BUT, Oxford

Project Number

2017/900/93

References

• 1.Golden MI, Fries PL. Dry Eye Syndrome. StatPearls. Treasure Island (FL): StatPearls Publishing StatPearls Publishing LLC.; 2017.
• 2.Ayaki M, Kawashima M, Uchino M, Tsubota K, Negishi K. Possible association between subtypes of dry eye disease and seasonal variation. Clinical ophthalmology. (Auckland, NZ) 2017; 11: 1769-75.
• 3.Chen L, Pi L, Fang J, Chen X, Ke N, Liu Q. High incidence of dry eye in young children with allergic conjunctivitis in Southwest China. Acta ophthalmologica 2016; 94(8): e727-e30.
• 4.Thong BY. Allergic conjunctivitis in Asia. Asia Pacific allergy. 2017; 7(2): 57-64.
• 5.Galletti JG, Guzman M, Giordano MN. Mucosal immune tolerance at the ocular surface in health and disease. Immunology. 2017; 150(4): 397-407.
• 6.Dartt DA, Masli S. Conjunctival epithelial and goblet cell function in chronic inflammation and ocular allergic inflammation. Current opinion in allergy and clinical immunology. 2014; 14(5): 464-70.
• 7.Toda I, Shimazaki J, Tsubota K. Dry eye with only decreased tear break-up time is sometimes associated with allergic conjunctivitis. Ophthalmology. 1995; 102(2): 302-9.
• 8.Dogru M, Okada N ,Asano-Kato N,Tanaka M.,Igarashi A,Takano Y, et al. Atopic ocular surface disease: implications on tear function and ocular surface mucins. Cornea. 2005; 24(8 Suppl): S18-s23.
• 9.Hom MM, Nguyen AL, Bielory L. Allergic conjunctivitis and dry eye syndrome. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. 2012; 108(3): 163-6.
• 10.Lobefalo L,.D'Antonio E,Colangelo L,Della Loggia G ,Di Gioacchino M, Angelucci D, et al. Dry eye in allergic conjunctivitis: role of inflammatory infiltrate. International journal of immunopathology and pharmacology. 1999; 12(3): 133-7.
• 11.Fujishima H, Toda I, Shimazaki J, Tsubota K. Allergic conjunctivitis and dry eye. The British journal of ophthalmology.1996; 80(11): 994-7.
• 12.Bielory L. Role of antihistamines in ocular allergy. The American journal of medicine. 2002; 113 Suppl 9A: 34s-7s.
• 13.Kruse FE, Tseng SC. Retinoic acid regulates clonal growth and differentiation of cultured limbal and peripheral corneal epithelium. Investigative ophthalmology & visual science. 1994; 35(5): 2405-20.
• 14.Cho HK, Park MH, Moon JI. The effect of additional topical cyclosporine or vitamin A on the ocular surface during antiglaucoma medication administration. Ophthalmic research. 2012; 48(3): 139-45.
• 15.Chelala E, Dirani A, Fadlallah A, Fahd S. The role of topical vitamin A in promoting healing in surface refractive procedures: a prospective randomized controlled study. Clinical ophthalmology. (Auckland, NZ) 2013; 7: 1913-8.
• 16.Ubels JL, Edelhauser HF, Foley KM, Liao JC, Gressel P. The efficacy of retinoic acid ointment for treatment of xerophthalmia and corneal epithelial wounds. Current eye research. 1985; 4(10): 1049-57.
• 17.Schiffman RM, Christianson MD, Jacobsen G, Hirsch JD, Reis BL. Reliability and validity of the Ocular Surface Disease Index. Archives of ophthalmology. (Chicago, Ill : 1960) 2000; 118(5): 615-21.
• 18.McCarty CA, Bansal AK, Livingston PM, Stanislavsky YL, Taylor HR. The epidemiology of dry eye in Melbourne, Australia. Ophthalmology. 1998; 105(6): 1114-9.
• 19.Bron AJ, Evans VE, Smith JA. Grading of corneal and conjunctival staining in the context of other dry eye tests. Cornea. 2003; 22(7): 640-50.
• 20.Ozcan AA, Ersoz TR, Dulger E. Management of severe allergic conjunctivitis with topical cyclosporin a 0.05% eyedrops. Cornea. 2007; 26(9): 1035-8.
• 21.Villani E, Strologo M. D, Pichi F, Luccarelli S. V, De Cilla S, et al. Dry Eye in Vernal Keratoconjunctivitis: A Cross-Sectional Comparative Study. Medicine. 2015; 94(42): e1648.
• 22.Kim TH, Moon NJ. Clinical correlations of dry eye syndrome and allergic conjunctivitis in Korean children. Journal of pediatric ophthalmology and strabismus. 2013; 50(2): 124-7.
• 23.Akil H, Celik F, Ulas F, Kara IS. Dry Eye Syndrome and Allergic Conjunctivitis in the Pediatric Population. Middle East African journal of ophthalmology. 2015; 22(4): 467-71.
• 24.Geraldini M, Chong Neto HJ, Riedi CA, Rosario NA. Epidemiology of ocular allergy and co-morbidities in adolescents. Jornal de pediatria. 2013; 89(4): 354-60.
• 25.Hu Y, Matsumoto Y, Dogru M, Okada N, Igarashi A, Fukagawa K., et al. The differences of tear function and ocular surface findings in patients with atopic keratoconjunctivitis and vernal keratoconjunctivitis. Allergy. 2007; 62(8): 917-25.
• 26.Kobayashi TK, Tsubota K, Takamura E, Sawa M, Ohashi Y, Usui M. Effect of retinol palmitate as a treatment for dry eye: a cytological evaluation. Ophthalmologica Journal international d'ophtalmologie International journal of ophthalmology Zeitschrift fur Augenheilkunde. 1997; 211(6): 358-61.
• 27.Kim EC, Choi JS, Joo CK. A comparison of vitamin and cyclosporine a 0.05% eye drops for treatment of dry eye syndrome. Am J Ophthalmol. 2009; 147(2): 206-13.e3.
• 28.Selek H, Unlu N, Orhan M, Irkec M. Evaluation of retinoic acid ophthalmic emulsion in dry eye. European journal of ophthalmology. 2000; 10(2): 121-7.
• 29.Toshida H, Funaki T, Ono K, Tabuchi N, Watanabe S, Seki T, et al. Efficacy and safety of retinol palmitate ophthalmic solution in the treatment of dry eye: a Japanese Phase II clinical trial. Drug design, development and therapy. 2017; 11: 1871-9.
• 30.Cui X, Xiang J, Zhu W, Wei A, Le Q , Xu J , et al. Vitamin A Palmitate and Carbomer Gel Protects the Conjunctiva of Patients With Long-term Prostaglandin Analogs Application. Journal of glaucoma. 2016; 25(6): 487-92.
• 31.Johansen S, Heegaard S, Prause JU, Rask-Pedersen E. The healing effect of all-trans retinoic acid on epithelial corneal abrasions in rabbits. Acta ophthalmologica Scandinavica. 1998; 76(4): 401-4.
• 32.Soker S, Nergiz Y, Cakmak S, Bahceci S, Soker M. Conjunctival impression cytology and correlation with vitamin a levels in children with Down Syndrome. The Medical Journal of Goztepe Training and Research Hospital. 2010; 25(3): 121-5.
• 33.Kastl PR, Rosenthal WN, Batlle I, Karcioglu Z. Topical vitamin A ointment increases healing of cataract incisions. Annals of ophthalmology. 1987; 19(5): 175-7, 80.