Methods:
60 patients with a diagnosis or history of ocular allergies, allergic conjunctivitis, ocular itching or conjunctival chemosis were enrolled in a 35 day study. At baseline, eligible patients were given either loteprednol or olopatadine bid for 14 days, followed by a 7 day washout of the first medication. At day 21, the second medication was dispensed and treatment continued until day 35. Both patient and clinical observer were masked. Patient global self assessment and a 12 item Ocular Surface Disease Index © (OSDI) were recorded at baseline, days 14, 21 and 35. Other parameters included visual acuity, biomicroscopy, fluorescein corneal staining, applanation IOP and tear production with Schirmer’s test.
Results:
At day 14, OSDI improved by 55% with loteprednol and 26% with olopatadine. At the end (day 35), no significant differences were reported between the cohorts with global self assessment, drug tolerability, corneal staining or biomicroscopy. IOP and tear production remained constant at 14.0±0.4 mmHg and 20.0±1.7mm (OD and OS combined) respectively. Visual acuity improved from 20/33 to 20/25 in cohort B. 33 patients preferred loteprednol, while 27 patients preferred olopatadine (p<0.05).
Conclusions:
Both drugs demonstrated excellent safety and efficacy as bid treatments for allergic conjunctivitis. While there were no differences in IOP and tear production, loteprednol was more efficacious than olopatadine in reducing OSDI, and was chosen as the preferred medication by more patients than olopatadine.
Keywords: conjunctivitis • corticosteroids • drug toxicity/drug effects