Abstract：
This study sought to evaluate the efficacy of the isolated use of fluorometholone compared with the combined use of azelastine and fluorometholone for the treatment of severe allergic conjunctival disease (ACD). One hundred and eleven patients with severe ACD were randomized into two groups: one treated with topical 0.1% fluorometholone combined with 0.05% azelastine and the other with 0.1% fluorometholone alone. The Ocular Surface Disease Index (OSDI) and the signs of keratopathy, palpebral conjunctiva papillae and conjunctival congestion were scored before and at one, two and six weeks after treatment and compared between the groups. The intra-ocular pressure (IOP) was also monitored. There were no significant differences between the groups in the baseline mean scores of signs and OSDI scores, which gradually improved at all visits after therapy in both groups. Although the time effect was significant for all the parameters (all p < 0.001), the reduction in corneal involvement scores from week 2 to week 6 was insignificant in both groups (p = 0.460 for the steroids group and p = 0.074 for the combination group). All signs and symptoms were significantly more improved in the combination group than in the isolated group at each control visit. IOP remained stable at all visits (all p < 0.001), except one patient in each group had elevated IOP over 21 mmHg. While both the isolated use of fluorometholone and combined use of azelastine and fluorometholone are effective in alleviating the signs and symptoms of severe ACD, optimal response can be achieved with adjunctive treatment including azelastine.
摘要：
这项研究旨在评估与氮卓斯汀和氟米龙联合使用治疗严重过敏性结膜疾病（ACD）相比，单独使用氟米龙的疗效。将111例严重ACD患者随机分为两组：一组接受0.1％氟米龙联合0.05％氮卓斯汀的局部治疗，另一组仅接受0.1％氟米龙治疗。眼表疾病指数（OSDI）和角膜病变的体征，眼睑结膜乳头和结膜充血在一次之前和一次进行评分，治疗2周和6周后进行组间比较。还监测眼内压(IOP)。在体征的基线平均得分和OSDI得分方面，两组之间没有显着差异。两组在治疗后的所有访问中逐渐改善。尽管时间效应对所有参数都是显著的(所有p<0.001)，从第2周至第6周,两组角膜受累评分的降低均不显著(类固醇组p=0.460,联合组p=0.074).在每次对照访问时，组合组的所有体征和症状都比单独组的改善明显。所有访视时IOP均保持稳定（均p<0.001），除了每组中的一名患者IOP升高超过21mmHg。虽然单独使用氟米龙和联合使用氮卓斯汀和氟米龙可有效缓解严重ACD的体征和症状，包括氮卓斯汀在内的辅助治疗可以达到最佳反应。
