Topical treatments for blepharokeratoconjunctivitis in children

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Clinical Trials

Background:

• Blepharokeratoconjunctivitis (BKC) is an inflammatory eye condition affecting children, potentially causing vision loss.
• Chronic inflammation can lead to corneal scarring and opacity.
• Current treatments focus on meibomian gland dysfunction, bacterial flora, and ocular surface inflammation.

Purpose of the Study:

• To assess and compare the efficacy and safety of topical treatments for BKC in children aged 0-16 years.
• To evaluate topical antibiotics, steroids, immunosuppressants, and lubricants, alone or in combination.
• To synthesize data from randomized controlled trials on topical BKC treatments.

Main Methods:

• Searched multiple databases (CENTRAL, MEDLINE, Embase, etc.) for relevant trials up to July 2016.
• Included randomized controlled trials (RCTs) of topical treatments for pediatric BKC.
• Included studies with various comparison groups (placebo, active treatments) and adjunctive therapies.

Main Results:

• Included one US-based RCT with 137 children (0-6 years) evaluating loteprednol etabonate/tobramycin, loteprednol alone, tobramycin alone, or placebo.
• The study had high risk of bias and was underpowered to detect differences in efficacy or adverse events.
• No significant differences in outcomes were found between groups; evidence quality was very low.

Conclusions:

• High-quality evidence on the safety and efficacy of topical BKC treatments in children is lacking.
• Uncertainty exists regarding the indications and effectiveness of current topical treatments.
• Further clinical trials with robust outcome measures are essential for evaluating pediatric BKC therapies.