A comparative study of azelastine, cromolyn and olopatadine ophthalmic solution in vernal keratoconjunctivitis in a tertiary care hospital-open label parallel group study design

Abstract

Background: Vernal keratoconjunctivitis (VKC) is a chronic, bilateral, external ocular inflammatory disease primarily affecting young boys living in warm, dry climates with seasonal variations. The disease causes lot of discomfort to the patient and sometimes can predispose to serious problems like shield ulceration and keratoconus. A number of drugs are used in the management of the condition, with variable results. The aims and objectives of this study was to compare the efficacy and safety of the drugs, cromolyn sodium, azelastine and olopatadine ophthalmic solutions in the treatment of VKC.Methods: Sixty patients of VKC were studied over a period of 6 weeks. They were divided into 3 groups randomly to receive one of the drugs under study. Symptoms and signs were recorded after detailed questioning and examination according to modified criterion of Tabbara and Arafat.Results: There was significant reduction in the mean itching scores with olopatadine as compared to cromolyn sodium and azelastine (p<0.05). Olopatadine significantly decreased mean lacrimation scores as compared to cromolyn sodium and azelastine (p<0.005). Olopatadine, cromolyn and azelastine showed significant reduction of corneal stippling, but no drug was significantly better than the other. Both cromolyn and olopatadine showed reduction of limbal edema equally (p<0.05), olopatadine reduced limbal edema more significantly as compared to azelastine (p<0.05).Conclusions: All the three drugs were found to be safe in the treatment of VKC. Olopatadine may be preferred over the other two drugs since it reduced both itching and discharge most significantly.