Olopatadine eye drops superior to fluticasone nasal spray for allergic conjunctivitis

Steroid nose sprays improve eye symptoms of AR/AC -  mechanism is unknown, but it might relate to naso-ocular reflex (http://goo.gl/VVt8k).

Olopatadine hydrochloride is an antihistamine and mast cell stabilizer, sold as a prescription eye drops (trademark Pataday, 0.2.%, QD or Patanol, 0.1%, BID), manufactured by Alcon). A nasal spray formulation is sold as trademark Patanase.


Olopatadine. Image source: Wikipedia, public domain.


Fluticasone furoate, Veramyst (US) and Avamys (EU and Canada), is different in structure from fluticasone propionate (see below). Image source: Wikipedia, public domain.


Fluticasone propionate, Flonase (US and Canada) Flixonase (EU and Brazil). Image source: Wikipedia, public domain.

In a study of 60 patients, olopatadine 0.2% ophthalmic solution showed superiority over fluticasone furoate nasal spray for ocular itching, redness, tearing, chemosis, and eyelid swelling.

The authors concluded that olopatadine was statistically and clinically superior to fluticasone nasal spray for the relief of signs and symptoms of allergic conjunctivitis.

Fluticasone furoate nasal spray is the only intranasal corticosteroid to reduce the ocular symptoms of seasonal allergic rhinitis consistently, JACI, 2010. http://goo.gl/oQ2n2


Classification of ocular allergy


Medications for Allergic Conjunctivitis



Ocular antihistamines (eye drops) (click to enlarge the image)


Ocular allergy. V. Dimov, M.D., 09/2008.

References:

A comparison of olopatadine 0.2% ophthalmic solution versus fluticasone furoate nasal spray for the treatment of allergic conjunctivitis. Rosenwasser, Lanny et al. Allergy and Asthma Proceedings, Volume 29, Number 6, November/December 2008 , pp. 644-653(10)
Ocular Allergy: Allergic Conjunctivitis and Related Conditions, a Short Review
Mind Maps: Allergic Conjunctivitis
Mnemonics: Allergic Conjunctivitis
Vernal Keratoconjunctivitis - NEJM images, 2012.