ABSTRACT
OBJECTIVE: To determine the benefit of early addition of corticosteroids to antibiotics in the treatment of corneal ulcers. DESIGN: Randomized clinical trial. PARTICIPANTS: Thirty eyes of 30 patients, over the age of 12 years, with bacterial corneal ulcer confirmed by culture. METHODS: Patients were randomized before enrollment; 15 were treated with gatifloxacin (Zymar) and a masked placebo and the other 15 were treated with gatifloxacin and masked dexamethasone 0.1% (Maxidex). Primary outcome was residual ulcer size at 10 weeks based on digital photographs. Secondary outcomes included residual ulcer area by clinician estimate, visual acuity, VF-14 score, and time to healing. RESULTS: All subjects (n = 30) demonstrated a reduction in ulcer size over the study period. There was no significant difference between the 2 groups in terms of the primary outcome. There was a significant difference between the 2 groups in 1 of the secondary outcomes. The mean residual ulcer size compared with the baseline by clinician estimate (slit-lamp) was -0.789 mm2 for the antibiotic-only group and -4.206 mm2 for the antibiotic-steroid group (p = 0.05). Among the other secondary outcomes there were no significant differences between the 2 groups. CONCLUSIONS: No benefit was demonstrated in our primary outcome for using steroids in combination with antibiotic therapy in treatment of corneal ulcers. This study suggests that the early addition of steroids to the antibiotic treatment of corneal ulcers does not seem to be harmful when employed in a closely monitored clinical setting.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Corneal Ulcer/drug therapy , Eye Infections, Bacterial/drug therapy , Glucocorticoids/therapeutic use , Adult , Bacteria/isolation & purification , Corneal Ulcer/microbiology , Dexamethasone/therapeutic use , Double-Blind Method , Drug Therapy, Combination , Eye Infections, Bacterial/microbiology , Female , Fluoroquinolones/therapeutic use , Gatifloxacin , Humans , Male , Middle Aged , Quality of Life , Visual Acuity/physiologyABSTRACT
BACKGROUND: As part of a larger systematic review on the effect of omega-3 fatty acids on eye health, the aim of this report was to appraise and synthesize the evidence for the effects of omega-3 fatty acids in slowing down the progression of age-related macular degeneration (AMD) and/or decreasing the rate of progression to advanced forms of AMD. METHODS: A comprehensive search was undertaken in six databases (MEDLINE, PreMEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, CAB Health, and Dissertation Abstracts). RESULTS: Two unique studies, one randomized clinical trial (RCT) and one prospective cohort study, satisfied the eligibility criteria and were included in the review. The RCT reported evidence on the effect of omega-3 fatty acids in slowing down the progression of AMD. The prospective cohort study addressed the question: what is the evidence that omega-3 fatty acids decrease the rate of progression to advanced forms of AMD? CONCLUSIONS: Clinical research on this topic is scarce. Only two studies were eligible to be included in this review. Although one study result indicated efficacy of preventing AMD progression to its advanced form, this result needs to be duplicated and supported by future research.
