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Jimena Tatiana Carreno-Galeano, Giulia Coco, Francisco Amparo, Reza Dana; Oral Guaifenesin for Treatment of Filamentary Keratitis. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3853.
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N-Acetylcysteine has shown some success, due to its mucolytic properties, in the treatment of filamentary keratitis. However, no trials to date have studied the therapeutic efficacy of oral guaifenesin (Mucinex ®), a well-tolerated and cost-effective over–the-counter drug, used for reducing respiratory tract secretions in filamentary keratitis. We performed a prospective, open label, non-controlled pilot study to determine whether systemic Guaifenesin is effective in reducing the number of corneal filaments and improving symptoms in patients with filamentary keratitis.
We enrolled six patients with filamentary keratitis. Main inclusion criteria were: 1) 18 years or older, 2) Schirmer test >3mm, and 3) presence of filaments. Main exclusion criteria were: 1) active ocular surface infection of any type, 2) history of allergy to guaifenesin, and 3) renal disease. At the baseline visit we evaluated visual acuity, number of corneal filaments, and ocular surface symptoms (OSDI). Patients were prescribed with 600mg extended-release Guaifenesin orally twice a day (1.2 g/day) for 4 weeks. We evaluated the same variables at a follow-up visit at week 4.
After four weeks of treatment with oral guaifenesin the number of corneal filaments decreased by 30% (median±SD, 6±2.48 vs. 4±4.4). There was also a 20% reduction in the Ocular Surface Disease Index scores with oral Guaifenesin treatment (45±18.5 vs. 32.5 ±19.9). There were no statistically significant differences in the number of filaments in the cornea (P=0.2) or the Ocular Surface Disease Index scores (P=0.2) between the pre- and post-treatment visits.
Our preliminary data shows a trend towards a lower number of corneal filaments and lower Ocular Surface Disease Index scores after Guaifenesin treatment. Further studies with more subjects are required to establish a definitive association between changes in these variables and treatment with Guaifenesin.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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