Abstract
Purpose We compared tear leukotriene B4 (LTB4) and leukotriene C4 (LTC4) levels of vernal keratoconjunctivitis (VKC) patients with those of age-matched controls and evaluated the effects of disodium cromoglycate (DCG) 2%, lodoxamide 0.1% and fluorometholone 0.1% on the tear LTB4 and LTC4 levels of the VKC patients.
Methods Thirty VKC patients were divided into three groups and their tear LTB4 and LTC4 levels measured with an enzyme-linked immunoassay technique before and after treatment with either lodoxamide 0.1%, DCG 2% or fluorometholone 0.1%. The results were compared with the tear LTB4 and LTC4 levels of 10 healthy control subjects. During this trial period, clinical scores for signs and symptoms of VKC were also evaluated.
Results In the VKC patients median tear LTB4 and LTC4 levels were 349.0 pg/ml (range 213.3-707,7 pg/ml) and 225.2 pg/ml (range 196.1-241.1 pg/ml) respectively - significantly higher than the control group (p = 0.0065 for LTB4 and p = 0.0003 for LTC4). After treatment, LTB4 levels decreased significantly in all treatment groups when compared with baseline (for the lodoxamide group, p = 0.01; for the DCG group, p = 0.008; for the fluorometholone group, p = 0.045). LTC4 levels were also significantly reduced after treatment in all three treatment groups (for the lodoxamide group, p = 0.0209; for the DCG group, p = 0.0284; for the fluorometholone group, p = 0.0109).
Conclusions Tear LTB4 and LTC4 levels are significantly higher in VKC patients than controls, which points to a possible role of lipoxygenase pathway products in the pathophysiology of ocular allergic disorders. Lodoxamide 0.1%, DCG 2% and fluorometholone 0.1% were all effective in reducing LTB4 and LTC4 levels in VKC.
Similar content being viewed by others
Article PDF
References
Allansmith MR, Ross RN . Ocular allergy. Clin Allergy 1988;18:1–13.
Ehlers WH, Donshik PC . Allergic ocular disorders: a spectrum of diseases. CLAO J 1992;18:117–24.
Caldwell DR, Verin P, Hartwich-Young R, Meyer SM, Drake MM . Efficacy and safety of lodoxamide 0.1% vs cromolyn sodium 4% in patients with vernal keratoconjunctivitis. Am J Ophthalmol 1992;113:632–7.
Allansmith MR . Immunology of the eye. In: Allansmith MR, editor. The eye and immunology. St Louis: CV Mosby, 1982:99–115.
Collin HB, Allansmith MR . Basophils in vernal conjunctivitis in humans: an electron microscopic study. Invest Ophthalmol Vis Sci 1977;16:858–65.
Abelson MB, Madivale N, Weston JF . Conjunctival eosinophils in allergic ocular disease. Arch Ophthalmol 1983;101:631–6.
Bacon AS, Tuft SJ, Metz DM, McGill J, Buckley RJ, Baddeley S, Lightman SL . The origin of keratopathy in chronic allergic eye disease: a histopathological study. Eye 1993;7(Suppl):21–5.
Abelson MB, Schaefer K . Conjunctivitis of allergic origin: immunologic mechanisms and current approaches to therapy. Surv Ophthalmol 1993;38(Suppl):115–29.
Leonardi A, Borghesan F, Avarello A, Plebani M, Secchi AG . Effect of lodoxamide and disodium cromoglycate on tear eosinophil cationic protein in vernal keratoconjunctivitis. Br J Ophthalmol 1997;81:23–6.
Goetzl EJ . Inflammation and hypersensitivity. Int Ophthalmol Clin 1985;25:25–34.
Nathan H, Naveh N, Meyer E . Levels of prostaglandin E2 and leukotriene B4 in tears of vernal conjunctivitis patients during a therapeutic trial with indomethacine. Doc Ophthalmol 1994;85:247–57.
Bisgaard H, Ford-Hutchinson AW, Charleson S, Tauderf E . Production of leukotrienes in human skin and conjunctival mucosa after specific allergen challenge. Allergy 1985;40:417–23.
Spada CS, Woodward DF, Mawley SB, Nieves AL . Leukotrienes cause eosinophil emigration into conjunctival tissue. Prostaglandins 1986;31:795–809.
Irkeç M, Orhan M . Effect of extended wear disposable contact lenses on tear LTC4 in giant papillary conjunctivitis. Ocular Immunol Inflamm 1995;3:107–11.
Buckley RJ . Vernal keratoconjunctivitis. Int Ophthalmol Clin 1988;28:303–12.
O'Flaherty JT, Showell HJ, Becker EL . Role of arachidonic acid derivatives in neutrophil aggregation: a hypothesis. Prostaglandins 1979;17:915–27.
Abelson ME, Weston JH . Mediators of ocular inflammation. In: Duane TD, Jaeger EA, editors. Biomedical foundations of ophthalmology, vol. 2. Philadelphia: JB Lippincott, 1985:1–9.
Smedegard G, Hedqvist P, Dahlen SE . Leukotriene C4 effects pulmonary and cardiovascular dynamics in monkey. Nature 1982;295:327–9.
Levi R, Burke JA, Corey EJ . SRS-A, leukotrienes and immediate hypersensitivity reactions of the heart. Adv Prostaglandin Thromboxane Leukot Res 1982;9:215–22.
Yanni JM, Weimer LK, Glaser RL, Lang LS, Robertson SM, Spellman JM . Effect of lodoxamide on in vitro and in vivo conjunctival hypersensitivity response of rats. Int Arch Allergy Immunol 1993;101:102–6.
Kulkarni PS, Srinivasan BD, Kaufman P . Comparison of cyclooxygenase and lipoxygenase pathways in rabbit and monkey ocular tissues [abstract]. Invest Ophthalmol Vis Sci 1985;26(Suppl):191.
Santos CI, Huang AJ, Abelson MB, Foster CS, Friedleander M, McCulley JP . Efficacy of lodoxamide 0.1% ophthalmic solution in resolving corneal epitheliopathy associated with vernal keratoconjunctivitis. Am J Ophthalmol 1994;117:488–97.
Hennawi ME . A double blind placebo controlled group comparative study of ophthalmic sodium cromoglycate and nedocromil sodium in treatment of vernal keratoconjunctivitis. Br J Ophthalmol 1994;78:365–9.
Author information
Authors and Affiliations
Corresponding author
Additional information
The authors do not have any financial interest in any of the drugs used in this study
Rights and permissions
About this article
Cite this article
Akman, A., Irkeç, M. & Orhan, M. Effects of lodoxamide, disodium cromoglycate and fluorometholone on tear leukotriene levels in vernal keratoconjunctivitis. Eye 12, 291–295 (1998). https://doi.org/10.1038/eye.1998.67
Issue Date:
DOI: https://doi.org/10.1038/eye.1998.67