Usefulness of a new therapy using rebamipide eyedrops in patients with VKC/AKC refractory to conventional anti-allergic treatments.
BACKGROUND
Rebamipide, a gastroprotective drug, has been reported to suppress gastric mucosal inflammation. In Japan, rebamipide eyedrops have recently been approved for the treatment of dry eye disease. Some patients with allergic conjunctival diseases such as vernal keratoconjunctivitis (VKC) or atopic keratoconjunctivitis (AKC) manifest dry eye with decreased tear break-up time only. We report patients with VKC/AKC refractory to anti-allergic treatments who responded to the combination of rebamipide eyedrops and conventional anti-allergic treatments with anti-allergic- and/or immunosuppressive/steroid eyedrops.


METHODS
Four patients with allergic conjunctival diseases with giant papillae (VKC or AKC) instilled rebamipide eyedrops three or four times a day for varying periods. All had dry eye with decreased tear break-up time. We evaluated changes in the size of their giant papillae using Image J software.


RESULTS
We observed attenuation of the giant papillae in all 4 patients. In 2 patients with severe disease, whose giant papillae had become larger despite the administration of tacrolimus and steroids, the addition of rebamipide contributed to their attenuation. In 2 patients with mild disease, the giant papillae had become larger or remained the same size despite the administration of anti-allergy drugs; the addition of rebamipide eyedrops also resulted in the attenuation of their giant papillae.


CONCLUSIONS
Our findings suggest that rebamipide eyedrops might attenuate giant papillae in patients with allergic conjunctival diseases and that these eyedrops may be useful for the treatment of not only dry eye but also of allergic conjunctival diseases.
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan; Faculty of Life and Medical Sciences, Doshisha University, Kyoto, Japan.
Mayumi
M
Ueta
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Chie
C
Sotozono
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan; Faculty of Life and Medical Sciences, Doshisha University, Kyoto, Japan.
Ayaka
A
Koga
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Norihiko
N
Yokoi
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Shigeru
S
Kinoshita
D000293:Adolescent; D000328:Adult; D000409:Alanine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D018926:Anti-Allergic Agents / Q000008:administration & dosage*; D002648:Child; D003233:Conjunctivitis, Allergic / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D015363:Quinolones / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
D018926:Anti-Allergic Agents; D009883:Ophthalmic Solutions; D015363:Quinolones; C052785:rebamipide; D000409:Alanine