Changes in corneal thickness, upper and lower tear film in seasonal allergic conjunctivitis by steroid treatment: anteri
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ORIGINAL PAPER
Changes in corneal thickness, upper and lower tear film in seasonal allergic conjunctivitis by steroid treatment: anterior segment optical coherence tomography study Volkan Yeter
. Nurullah Koc¸ak . Hilal Eser-Ozturk
Received: 24 February 2020 / Accepted: 2 May 2020 Ó Springer Nature B.V. 2020
Abstract Purpose To evaluate the effects of loteprednol etabonate on cornea and tear film in patients with seasonal allergic conjunctivitis by anterior segment optical coherence tomography (OCT). Methods The right eyes of 52 subjects with seasonal allergic conjunctivitis were evaluated in the study. Central corneal thickness (CCT), the thicknesses of central corneal epithelium (CET) and central nonepithelial cornea (CnET), and lower and upper tear meniscus areas were measured by spectral-domain OCT and ocular surface disease index (OSDI) were obtained at baseline. After topical use of loteprednol etabonate 0.5% eye drop three times a day for 1 week, the measurements were repeated. Paired T test was used for analysis. Results Mean CCT and mean thicknesses of CET and CnET at baseline were 528.19 ± 34.47 lm, 64.10 ± 5.30 lm and 462.84 ± 33.43 lm, respectively, and these were 526.31 ± 33.37 lm, 64.65 ± 4.84 lm and 459.84 ± 32.11 lm after the treatment, respectively. OSDI score was 21.55 ± 4.40 at baseline and 13.13 ± 2.39 after 1 week. The lower and upper tear meniscus areas at baseline were 0.026 ± 0.017 mm2 and 0.017 ± 0.007 mm2, respectively, and they were 0.017 ± 0.009 mm2 and V. Yeter (&) N. Koc¸ak H. Eser-Ozturk Department of Ophthalmology, Ondokuz Mayıs University, 55139 Samsun, Turkey e-mail: [email protected]
0.016 ± 0.007 mm2, respectively, after the treatment. There is statistically significant difference between before and after values of CCT, CnET, lower tear meniscus area and OSDI score (p \ 0.05). Conclusion There is no change in corneal epithelial thickness and upper tear meniscus area after 1-week treatment with loteprednol etabonate in patients with seasonal allergic conjunctivitis, but it may cause decrease in non-epithelial corneal thickness and lower tear meniscus area. Keywords Loteprednol etabonate Cornea Thickness Tear Meniscus
Introduction Different applications of corticosteroids are widely used for the treatment of any ocular inflammation in ophthalmology practice. Because they have immediate and long-standing effects on ocular surface inflammations, they may be the most effective and practical choice for treating different manifestations of ocular allergy. But, corticosteroid therapy for allergic conjunctivitis is generally limited because the risk of corticosteroid-induced increase in intraocular pressure [1] and cataract development [2] after long-term corticosteriod use.
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Although loteprednol etabonate (LE) is structurally similar to other corticosteroids such as prednisolone acetate, it has no ketone group at position 20 and is classified as C20 ester-based corticosteroid [3]. This structura
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