title: Changes in tear function and the ocular surface after topical olopatadine treatment for allergic conjunctivitis: an open-label study.
abstract: BACKGROUND
  Olopatadine hydrochloride 0.1% eye drops represent a new class of anti-allergic agent with combined antihistaminic and mast cell-stabilizing properties.
  
  
  OBJECTIVE
  The purpose of this study was to describe alterations in tear function and the ocular surface in patients with allergic conjunctivitis and to analyze the effect of topical olopatadine treatment on corneal sensitivity, tear function, and impression cytology variables.
  
  
  METHODS
  This was a single-center, 3-visit, prospective, open-label study conducted in patients with allergic conjunctivitis. Patients received 1 drop of topical olopatadine hydrochloride 0.1% BID for 3 weeks. At each visit, patients and healthy control subjects underwent routine ophthalmic examinations and measurements of corneal sensitivity and tear function (Schirmer test of tear quantity, tear film break-up time [BUT], fluorescein staining of the cornea). All control subjects and a subgroup of patients also underwent conjunctival impression cytology for assessment of squamous metaplasia and goblet cell density. The outcomes of interest were changes in corneal sensitivity, tear function, and impression cytology variables after 3 weeks of treatment with olopatadine eye drops, both in patients with allergic conjunctivitis and between patients and controls.
  
  
  RESULTS
  At enrollment, the study included 46 eyes of 23 patients (9 men, 14 women; age range, 20-42 years) with allergic conjunctivitis; results were calculated based on the 21 patients who completed the study. The control group consisted of 70 eyes of 35 healthy subjects (13 men, 22 women; age range, 22-39 years). Before treatment, 64.3% of the eyes of patients with allergic conjunctivitis had a fluorescein staining score of >1 point, whereas after treatment, 14.3% had a score of >1 point (P < 0.001). Patients' mean (+/- SD) corneal sensitivity improved to 55.0 +/- 2.5 mm from the pretreatment value of 42.5 +/- 2.5 mm (P < 0.001). Mean BUT values before and after treatment were 8.1 +/- 3.5 and 14.0 +/- 7.0 seconds, respectively (P < 0.001). Before treatment, patients' mean squamous metaplasia grade was 2.5 +/- 0.5; at the end of treatment, it had decreased to 1.0 +/- 0.5 (P < 0.001). The mean pretreatment goblet cell density of 545 +/- 85 cells/mm2 improved to 1,090 +/- 100 cells/mm2 after treatment (P < 0.001).
  
  
  CONCLUSIONS
  In the patient population studied, the disorder of tear function, squamous metaplasia, and loss of ocular surface goblet cells associated with allergic conjunctivitis improved with topical olopatadine treatment.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Uludag University, Bursa, Turkey. muratodooru@yahoo.com
authors.forename: Murat
authors.initials: M
authors.lastname: Dogru
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ozmen
authors.forename: Haluk
authors.initials: H
authors.lastname: Ertürk
authors.forename: Ozgür
authors.initials: O
authors.lastname: Sanli
authors.forename: Ali
authors.initials: A
authors.lastname: Karatas
mesh_terms: D000328:Adult; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D003233:Conjunctivitis, Allergic / Q000188:drug therapy*; D003315:Cornea / Q000166:cytology / Q000187:drug effects*; D003990:Dibenzoxepins / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D000069605:Olopatadine Hydrochloride; D013666:Tears / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D018926:Anti-Allergic Agents; D003990:Dibenzoxepins; D000069605:Olopatadine Hydrochloride