Comparison of lodoxamide 0.1% ophthalmic solution and levocabastine 0.05% ophthalmic suspension in vernal keratoconjunctivitis.

PURPOSE: To compare the clinical efficacy and safety of lodoxamide 0.1% ophthalmic solution with levocabastine 0.05% ophthalmic suspension, each given four times daily (QID) for three months to patients with vernal keratoconjunctivitis (VKC). METHODS: The study was conducted multinationally according to a triple-masked parallel design in 95 VKC patients, with assessments at baseline then monthly during the three months of treatment. The primary efficacy variables were a Physician's Clinical Judgement Scale and a Patient's Overall Judgement Scale of improvements from baseline. Signs and symptoms of VKC were also assessed. RESULTS: Both primary efficacy variables showed significantly greater overall improvement of VKC from baseline with lodoxamide than levocabastine. The superiority of lodoxamide was demonstrated by the Physician's Clinical Judgement Scale at months 2 and 3, with a trend, at month 1, and by the Patient's Overall Judgement Scale at months 1, 2 and 3. All signs and symptoms of VKC improved significantly from baseline at all time points, regardless of treatment (p<0.001). However, relative to levocabastine, conjunctival discharge, photophobia and lacrimation were significantly reduced by lodoxamide at months 1, 2 and 3, itching at months 2 and 3, and bulbar conjunctiva at month 3. The temporal improvement of superior tarsal papillae did not differ significantly between treatments. Both were well tolerated. CONCLUSIONS: Lodoxamide 0.1% and levocabastine 0.05% eye drops, instilled four times daily for three months, were effective, safe and well tolerated by patients with VKC, but lodoxamide was significantly superior to levocabastine.

High field resolution magnetic resonance imaging of malignant choroidal melanoma.

High resolution surface receiver coil nuclear magnetic resonance imaging (MRI) of the eye and paraorbital areas was performed in a patient with a malignant choroidal melanoma before and after local radiotherapy using ruthenium application. The resulting improvement in signal-to-noise ratio allows for a reduction in the imaging voxel size to 0.31 X 0.31 X 3 mm3 which provided useful morphological information with respect to delineation of tumoral mass. In the same MRI session using a standard head coil imaging method, T1 and T2 relaxation time values were calculated in regions of interest of 3 X 3 mm by means of transversal scan images of orbital and cranial tissues performed in scan times of 7 to 9 minutes. The procedure presented here combines in one single session high resolution imaging performance, previously unobservable in MRI and in other noninvasive imaging techniques, with fast and reliable measurement of T1 and T2 relaxation times within small regions of interest. MRI, a non ionizing technique, offers within reasonable acquisition times not only a good multiplanar description of the site, size and volume of normal and pathologic orbital structures, but, in addition, the prospect of soft tissue differentiation and of accurately documenting the response to and side effects of the therapy of ocular tumors.