ABSTRACT
ABSTRACT Purpose: To evaluate the use of supratarsal injection of triamcinolone acetonide in severe vernal keratoconjunctivitis (VKC) in children. Methods: Patients included in this open clinical trial were those with severe VKC-associated with keratitis, gelatinous limbal infiltrates, and/or giant papillae, with a history of recurrence and resistance to conventional topical antiallergic agents. Patients were treated with a supratarsal injection of 20 mg triamcinolone acetonide. Results: Analysis included 27 injections in 23 eyes of 17 patients with severe allergic keratoconjunctivitis. Mean age was 12.3 (range: 7-19) years. Mean follow-up time was 39.3 months (SD=19.21). In the 17 patients, the disease was successfully controlled for an average of 3.6 months (range: 1-16), during which allergy symptoms and signs were significantly improved, with complete resolution of lid edema and conjunctival chemosis, significant decline of pannus and keratitis, and reduction of giant papillae size. Conclusion: Treatment of severe, acute VKC in children with supratarsal injection of 20 mg triamcinolone acetonide showed satisfactory results and was well tolerated by patients; it may therefore constitute a safe option for severe and challenging cases. While full disease remission was not achieved, a significant improvement was found in ocular allergy symptoms and signs, with a reduction in the frequency of acute recurrences.
RESUMO Objetivo: Avaliar o uso da injeção supratarsal de triancinolona na ceratocon junti vite primaveril grave (VKC) em crianças. Métodos: Pacientes com VKC grave associada à ceratite, limbo gelatinoso e/ou papilas gigantes, com história de recidivas e resistência a agentes antialérgicos tópicos convencionais foram incluídos neste ensaio clínico. Os pacientes foram tratados com injeção de 20 mg de acetato de triancinolona supratarsal. Resultados: A análise incluiu 23 olhos de 17 pacientes com ceratoconjuntivite alérgica grave. A idade média foi de 12,3 com intervalo de 7-19 anos. O tempo médio de acompanhamento foi de 39,3 meses (DP 19,21). Dos 17 pacientes, a doença foi controlada com sucesso por uma média de 3,6 meses (intervalo 1-16) em que os sinais e sintomas foram significativamente melhorados com resolução completa do edema palpebral e quemose conjuntival, redução significativa de pannus, ceratite e redução do tamanho das papilas gigantes. Conclusão: O tratamento da VKC grave em crianças com injeção supratarsal de 20 mg de acetato de triancinolona mostrou resultados satisfatórios, sendo bem tolerada pelas crianças às quais foram submetidas, podendo constituir uma opção segura para casos graves e difíceis de VKC. Uma melhora significativa foi encontrada nos sinais e sintomas alérgicos oculares, com diminuição da frequência de recidivas agudas, no entanto sem se mostrar efetiva para a completa remissão da doença.
Subject(s)
Humans , Male , Female , Child , Adolescent , Young Adult , Conjunctivitis, Allergic/drug therapy , Triamcinolone Acetonide/administration & dosage , Injections, Intraocular , Glucocorticoids/administration & dosage , Time Factors , Prospective Studies , Reproducibility of Results , Treatment Outcome , Age of Onset , Eyelids/drug effects , Administration, Ophthalmic , Medical IllustrationABSTRACT
Pseudomonas aeruginosa was inoculated into corneal stroma of rabbits and the model of keratoconjunc tivitis was established. Empty liposomes were used in a control, group ofloxacin liposome and ofloxacin eyedrop groups as experimental ones. After treatment for six times conjunctival and corneal lesions were examinated. Swabs of conjunctival sac were cultured. Result: in conjunctiva, lesions in the two experimental groups were all significantly less than those in the control group on the 6th, 8th and 11th day. Lesions in the ofloxacin liposomes group were also significantly less than those in the ofloxacin eyedrop group on the6th day. In cornea, lesions in the ofloxacin liposomes group were significantly less than those in the control group on the 6 th, 8th and 11th day. Lesions in the ofloxacin eyedrop group were significantly less than those the control group on the 11th day. In the result of bacterium culture, the culture's positive rate of two experimental gronqs and control group had significant differences on the 6th day. On the 11th day, the positive rate the ofloxacin liposome groups and ofloxacin eyedrop groups increased, and in the ofloxaein liposomes group had a less increase. Conclusion: ofloxacin liposomes and ofloxacin eyedrops were effective in treatments of pseudomonas keratoconjuntivitis in the rabbit model, the effects of ofloxacin liposomes were better than that of ofloxacin eyedrops.