Clinical Experience of Using 0.2 % Olopatadin in the Allergic Conjunctivitis Treatment

Purpose: to evaluate the efficacy and safety of complex therapy of allergic conjunctivitis, including 0.2 % olopatodin. Patients and methods: In 40 allergic conjunctivitis (AK) patients were performed: assessment of the intensity of itching and tearing, as well as conjunctival hyperemia and folliculosis (points); Schirmer’s test (SHT; mm); tear film break up time (TFBUT, s); assessment of the lid wiper epitheliopathy symptom (LWES, points); calculation of the xerosis indicator (XI; points, according to Bijsterveld). In the 1 group (20 pollen AK patients) were given: 0.2 % olopatadine instillations (1 time per day); preservative free polyvinylpyrrolidone and polyvinyl alcohol fixed combination (2–3 times a day, from 7 days of therapy). Control points: 7 and 30 days of therapy. Patients of 2 group with pollen AK and chronic blepharitis (saprophytic flora and Demodex) were performed: 0.2 % olopatadine instillations (1 time per day); eyelid hygiene (poloxamer 188 and PEG-90 gel; 2 times per day); ointment containing gentamicin and dexamethasone (application on the eyelids margins, 2 times a day, 14 days); acaricidal gel (based on preparations of sulfur, sodium hyaluronate and aloe extract; 2 times a day, from 15 days of therapy); preservative free polyvinylpyrrolidone and polyvinyl alcohol fixed combination (2–3 times a day, from 15 days of therapy). Control points: 14 and 30 days of treatment. Statistical analysis included: calculation of an average and its standard deviation (М ± s); evaluation of reliability of differences in control points (Wilcoxon’s T-criterion; χ2 criterion). Statistically significant was p < 0,05. Results: Patients of both groups had good tolerability of the treatment; no significant systemic and local side effects of treatment were noted. In 1 group patients by the 7th and 30th day of therapy, a significant decrease in the severity of itching, tearing and conjunctival hyperemia was observed. By the 30th day of observation, the complete absence of itching was noted in 85 % of individuals, the absence of hyperemia — in 80 %. The rest of the observed severity of these signs did not exceed the level of one point, and their manifestations were non-permanent. Conjunctival follicular response significantly decreased by 30 days of observation. SHT showed a significant decrease in all control points, remaining within normal limits. Dynamics of TFBUT and XI by 7 days of therapy was unreliable. By the 30th day of treatment, there was a significant positive dynamics of TFBUT and XI, compared with the state before the therapy and 7 days of observation. At the same time, TFBUT and XI have reached values close to normal. In 2 group patients by the 14th and 30th day of therapy, a significant decrease in the severity of itching, tearing, hyperemia and follicular conjunctival reaction was recorded (by 1–2 points). The value of SHT showed a significant decrease in all control points (within the normal values of the indicator). By the 14th day of therapy, a significant decrease of LWES was noted; the NT and XI the dynamics were statistically insignificant. By the 30th day of observation, significant positive dynamics of NT, XI, and LWES were noted, compared with the state before the start of treatment and 14 days of therapy. Despite the almost complete relief of symptoms and signs of allergy and ocular surface condition improvement, by 30 days of observation, the magnitudes of NT, XI and LWES still did not reach the normal state, which determined the need for further artificial tear therapy, eyelid hygiene and acaricide treatment. Conclusion: Combined therapy, including 0.2 % olopatadin instillation, demonstrated high efficacy in relieving symptoms (itching, tearing) and signs (hyperemia and follicular conjunctival reaction) of allergic conjunctivitis, as well as a good safety profile.

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