olopatadine-hydrochloride and Dry-Eye-Syndromes

Ophthalmic disorders are highly prevalent in the United States, with approximately 3.5 million individuals aged at least 40 either blind or having impaired vision. This article reviews the current leading agents and pipeline therapies for the treatment of anterior ocular inflammatory disease (AOID).. There has been great progress in the understanding of ocular pathophysiology in recent years. Although current treatments for AOID are effective and well tolerated in many patients, a continued demand persists for more efficacious alternatives to the limited modalities available to clinicians.. Several promising modalities for AOID, particularly for allergic conjunctivitis, immune treatments for uveitis and dry eye syndrome are in late-stage development that could offer optimal treatment paradigm once available in the clinic.

Topics: Anti-Infective Agents; Antibodies, Monoclonal; Chemokine CCL11; Clinical Trials as Topic; Conjunctivitis, Allergic; Cyclosporine; Dibenzoxepins; Dry Eye Syndromes; Fluoroquinolones; Histamine H1 Antagonists; Humans; Immunotherapy; Levofloxacin; Moxifloxacin; Olopatadine Hydrochloride; Uveitis, Anterior

Olopatadine hydrochloride 0.2% (Pataday, Alcon, Fort Worth, USA) is a topical ocular anti-allergic agent that has shown high rates of efficacy in treating ocular itching, the primary symptom of allergic conjunctivitis, and allows for once-daily dosing. Since some patients suffer from signs or symptoms of dry eye in addition to ocular allergy, this study was designed to evaluate the safety of olopatadine 0.2% in a population of patients with both allergic conjunctivitis and dry eye.. This was a single-center, 3-visit, double-masked, randomized study. Fifty-two patients diagnosed with ocular allergy and mild-to-moderate dry eye were evaluated. After a run-in period, patients were randomized to receive either olopatadine hydrochloride 0.2% or a tear saline, and self-dosed once-daily for 1 week. Outcome measures included tear film break-up time, corneal and conjunctival staining, tear volume and flow as measured by fluorophotometry, Schirmer's test, injection, and symptom evaluations.. No significant differences between the treatment groups were observed (p > 0.05). No serious adverse events occurred during the trial. Variability in the presentation of dry eye can hinder the observation of treatment effects. Although the study design facilitated the comparison of olopatadine 0.2% against an agent that was certain to not exacerbate dry eye, future comparison of olopatadine 0.2% against other agents in its drug class would provide useful information about relative drug tolerabilities.. As there were no significant changes in the signs and symptoms of dry eye, olopatadine hydrochloride 0.2% is safe to use in ocular allergy patients with mild-to-moderate dry eye.

Topics: Anti-Allergic Agents; Conjunctivitis, Allergic; Dibenzoxepins; Dry Eye Syndromes; Female; Health Status Indicators; Humans; Male; Middle Aged; Olopatadine Hydrochloride; Ophthalmic Solutions; Sodium Chloride; Treatment Outcome

Mucus fishing syndrome (MFS) is a cascading cyclic condition characterized by continuous extraction of mucous strands from the eye. It is usually initiated by ocular irritation. In response to irritation, ocular surface cells produce excess mucus. A "snow balling" cycle begins when the patient extracts ("fishes") excess mucus from the ocular surface, thereby causing further irritation and a more-profound mucous discharge. To date, treatment includes eliminating the initiating element and educating the patient not to touch the eye when extracting the excess mucus,. Presented is a case of mucus fishing syndrome initiated by dry eye. The patient's diagnosis, MFS, was identified by persistent mucous discharge, his admittance and demonstration of digitally extracting mucus from the ocular surface, and a characteristic rose bengal staining pattern. The conventional treatment initiated by using artificial tears for the dry eye condition and educating the patient not to touch the ocular surface did not provide relief from the excess mucous discharge. Therefore, a new approach to treatment was pursued. In order to break the cycle, a mucolytic agent and an antihistamine-mast cell stabilizer were prescribed, until the ocular surface healed. After treatment, the patient reported alleviation of symptoms and demonstrated improvement in ocular surface integrity by a profound reduction in rose bengal staining.. Mucus fishing syndrome is challenging to resolve with conventional treatment because it requires a certain level of psychological tolerance and perseverance from the patient. By eliminating the present mucus and diminishing mucous production pharmacologically, the practitioner is able to remove the stimulus for digital extraction and thus accelerate ocular surface healing. We present a proposed new treatment option for patients who are refractory to conventional treatments.

Topics: Cystine; Dibenzoxepins; Drug Therapy, Combination; Dry Eye Syndromes; Histamine H1 Antagonists; Humans; Lacrimal Apparatus Diseases; Male; Middle Aged; Mucus; Olopatadine Hydrochloride; Rose Bengal; Syndrome