Systematic review and meta-analysis of randomised clinical trials on topical treatments for vernal keratoconjunctivitis

• Published in: British journal of ophthalmology Vol. 91; no. 12; pp. 1656 - 1661
• Main Authors: Mantelli, F, Santos, M S, Petitti, T, Sgrulletta, R, Cortes, M, Lambiase, A, Bonini, S
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.12.2007; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adrenal Cortex Hormones - administration & dosage; Adrenal Cortex Hormones - therapeutic use; Anti-Inflammatory Agents, Non-Steroidal - administration & dosage; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Antimitotic Agents - adverse effects; Antimitotic Agents - therapeutic use; Biological and medical sciences; Clinical trials; Conjunctivitis, Allergic - drug therapy; Diseases of cornea, anterior segment and sclera; Extended Report; Histamine H1 Antagonists - administration & dosage; Histamine H1 Antagonists - therapeutic use; Humans; Immunologic Factors - administration & dosage; Immunologic Factors - therapeutic use; Mast Cells - drug effects; Medical sciences; Medical Subject Headings-MeSH; Meta-analysis; Miscellaneous; Ophthalmic Solutions - therapeutic use; Ophthalmology; Quality; Randomized Controlled Trials as Topic; Software; Statistical analysis; Studies; Treatment Outcome; Systematic review; Keratopathy; Conjunctiva disease; Evidence-based medicine; Metaanalysis; Local administration; Eye disease; Chemotherapy; Keratoconjunctivitis; Randomization; Treatment; Clinical trial; Ophthalmology; Anterior segment disease; Topical administration
• ISSN: 0007-1161; 1468-2079; 1468-2079
• DOI: 10.1136/bjo.2007.122044

Aims:The aim of this study was to assess the efficacy of currently available topical drugs for vernal keratoconjunctivitis (VKC) through a meta-analysis of randomised clinical trials (RCTs).Methods:Twenty-seven RCTs (n = 2184 eyes) that had evaluated the efficacy of topical drugs for the treatment of VKC were selected according to the set criteria; 10 of these trials were suitable for statistical analysis and were enrolled in the meta-analysis. Articles published up to December 2005 were identified from the following data sources: Medline, Embase, Lilacs, the Cochrane Controlled Trials Register, and references from relevant articles. Articles in any language published with an English abstract, were screened, and those selected for inclusion were written in English, French, German, Italian, Portuguese or Spanish. The quality of the trials was assessed by the Delphi list. Statistical analysis was performed using STATA® software.Results:A significant improvement in all signs and symptoms, except photophobia, was observed after topical treatment for active VKC, independent of the type of treatment. Comparison of the efficacy of different drugs was not possible due to a lack of standardised criteria among studies.Conclusion:The currently available topical drugs are effective in treating acute phases of VKC. However, there is a lack of evidence to support the recommendation of one specific type of medication for treating this disorder. There is a need for standard criteria to assess diagnosis and therapy based on severity. There is also a need for RCTs assessing long-term effects of single drugs to control the disease and to prevent complications.