Novel Use Of Histoglob- The Wonder Drug In Vernal Keratoconjunctivitis

As VKC is a chronic condition, which has its exacerbations with dusty environmental conditions or may even be there throughout the year. So, to address this, we found the use of this immunoglobulin, as a safer modality which may prove to be a better treatment option. The main purpose to determine the naïve use of Histoglob in patients of VKC and to understand the use of Histoglob as a game changer in the field of ophthalmology

The Study was conducted in a tertiary care setting in the department of Cornea and Pediatric out patient department in which patients were enrolled as per the inclusionand exclusion criterion as mentioned below. Ethical clearance was taken from the Institutional board for the conduct of this pilot study.

As it is a pilot study, we planned to induct 15 patients who had history of chronic VKC in this prospective, interventional pilot study. 

   Inclusion criteria

• Patient attending the Department of Cornea/Pediatric Ophthalmology department, diagnosed with VKC , who were symptomatic for last 6 months
• Recurrent cases of VKC or who had been treated elsewhere for > 6months and presented to us as non resolving were also included. 
• Patients having Grade 3 of  :
  • Conjunctival Hyperemia 
  • Papillae Pappilae Size >0.3mm
  • Trantas Dots Grade 3- 6 dots
  • Superficial Punctate Keratopathy

Exclusion criteria

• Symptomatic patients of less than 6 months duration
• Those patients who are not willing to be a part of study

As per objective assessment of the VKC score,the mean score was 7.27 +/-2.58 (Baseline), 4.07 +/-1.94 (after 1^st dose), 2.4+/-1.5 (2^nd dose), 1.2+/-1.14 (3^rd dose) Out of 15, two cases were of steroid induced glaucoma and both patients responded well, where no topical steroids were given and were beneficial in such cases as well.

On comparing, baseline i.e. week 1 the mean +/- SD was 7.267+/-2.58 has seen a fall in trendline to 3^rd week mean +/- SD 1.2+/-1.14, with 95 % confidence interval with standard error 0.28 had a statistically significant p value of <0.0001.The steroid dependence had also drastically reduced from mean of 7.87 to 2.13 by the end of third week

To the best of our knowledge, till date no studies have yet been conducted in ophthalmology worldwide , which makes this pilot study a unique in its own way.  A newer horizon for an addition of In Histoglob provides both active and passive immunity, making it a newer promising modality for treatment of vernal keratoconjunctivitis.