Medical hypothesis, discovery & innovation in optometry

Add-on therapy with different non-steroidal anti-inflammatory agents in the management of non-infectious, non-necrotizing episcleritis

Medical hypothesis, discovery & innovation in optometry, Vol. 2 No. 4 (2021), 15 August 2022 , Page 133-137
https://doi.org/10.51329/mehdioptometry137

Abstract

Background: Episcleritis is a common ocular inflammatory disease that can cause red eye. It is usually managed using single or combined topical corticosteroids and topical or oral non-steroidal anti-inflammatory drugs (NSAIDs) as directed by clinical response. However, recurrence is possible. This study aimed to compare the effects of add-on therapies using different topical NSAIDs in the management of treatment-naive, non-infectious, non-necrotizing episcleritis.
Methods: Seventy-five eyes of 75 patients with non-infectious, non-necrotizing unilateral episcleritis were included in this study. Patients were allocated to one of three groups based on the NSAID used as add-on therapy: topical diclofenac sodium 0.1% (group D), topical nepafenac 0.1% (group N1), and topical nepafenac 0.3% (group N3). The time to symptom disappearance was defined as the recovery time.  
Results: There were no statistically significant differences in age, sex, initial best-corrected distance visual acuity, and intraocular pressure between groups (all P > 0.05). The mean recovery times of groups D and N1 were comparable (12.86 ± 5.35 days and 11.45 ± 5.42 days, respectively) (P > 0.05). However, the mean recovery time of group N3 was significantly shorter (9.70 ± 3.80 days, P < 0.05). Recurrence was observed in only one patient in group N1 at 3 months, and symptoms resolved when the same medication was reinstituted. Furthermore, we noted no side effects during the follow-up period for any of the treatment modalities. 
Conclusions: All three topical NSAIDs were effective add-on therapies in the management of non-infectious, non-necrotizing unilateral episcleritis. However, once-daily administration of topical nepafenac 0.3% had a shorter recovery time than topical diclofenac 0.1% and topical nepafenac 0.1%.
Keywords:
  • Anti-inflammatory agents
  • episcleritis
  • non-infectious
  • non-necrotizing
  • ocular surface
  • red eye
  • treatment

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