This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (6)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Pulmonary Diseases  • Asthma  • Immunology  • Allergy  • Corneal Disorders  • External Eye Disease  • Alert me on articles by topic

Alessandro Lambiase, MD; Stefano Bonini, MD; Guido Rasi, MD; Marco Coassin, MD; Alice Bruscolini, MD; Sergio Bonini, MD

Arch Ophthalmol. 2003;121:615-620.

Objective  To evaluate the effects on signs and symptoms of a coexisting vernal keratoconjunctivitis in patients treated with oral montelukast sodium for asthma.

Methods  Twelve patients with vernal keratoconjunctivitis and asthma were enrolled in this pilot study. Topical eyedrops or any systemic treatment was discontinued for at least 7 days before montelukast treatment. Patients were asked to grade their ocular discomfort daily. The following signs and symptoms were also recorded and graded through medical examination at baseline,after 15 days of treatment, and 15 days after treatment discontinuation: physician-evaluated tarsal and bulbarpapillae, hyperemia, secretion, and chemosis; and patient-evaluated itching, burning, tearing, photophobia, foreign body sensation, secretion, and redness. Peak expiratory flow rate at 8 AM was also recorded. Samples were collected at the same time points for enzyme-linked immunosorbent assay measurement of leukotriene B₄ in tears and leukotriene E₄ in urine.

Results  Eight of the 10 patients evaluated reported a reduction in symptoms at the end of treatment. Montelukast treatment significantly decreased physician-rated hyperemia, secretion, and chemosis as well as patient-rated burning, tearing, photophobia, secretion, and redness. Effects persisted 15 days after discontinuation of treatment. Clinical changes were associated with a significant increase in leukotriene B₄ in tears and a significant decrease in leukotriene E₄ in urine after 15 days of treatment.

Conclusion  The significant and persistent reduction of ocular signs and symptoms in asthmatic patients with vernal keratoconjunctivitis treated for 15 days with montelukast strongly suggests the need for double-masked placebo-controlled trials to confirm the potential of this new treatment in vernal keratoconjunctivitis.

From the Interdisciplinary Research Center, University "Campus Bio-Medico," Laboratory of Ophthalmology, Rome, Italy (Drs Lambiase, Stefano Bonini, Coassin, and Bruscolini); "G. B. Bietti" Eye Foundation, Rome (Drs Lambiase and Stefano Bonini); Institute of Neurobiology and Molecular Medicine, National Research Council, Rome (Dr Rasi and Sergio Bonini); and Department of Allergy and Clinical Immunology, II University of Naples, Naples, Italy (Dr Sergio Bonini). The authors have no relevant financial interest in this article.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Advances in Therapy with Antileukotriene Drugs
Riccioni et al.
Annals of Clinical & Laboratory Science 2004;34:379-387.
ABSTRACT | FULL TEXT