helmholtzeyeinstituteРоссийский офтальмологический журналRussian Ophthalmological Journal2072-00762587-5760Real time Publishers10.21516/2072-0076-2023-16-2-166-172helmholtzeyeinstitute-1252Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWSТопические глюкокортикостероиды в офтальмологии: сравнительный анализ эффективности и безопасностиTopical glucocorticoids in ophthalmology: a comparative analysis of efficacy and safetyhttps://orcid.org/0000-0002-6348-6867ЗыряновС. К.ZyryanovS. K.

Сергей Кенсаринович Зырянов, д-р мед. наук, профессор, заведующий кафедрой общей и клинической фармакологии, ул. Миклухо-Маклая, д. 6, Москва, 117198;

заместитель главного врача,  ул. Песцовая, д. 10, Москва, 127015

Sergey K. Zyryanov, Dr. of Med. Sci., professor, head of the department of general and clinical pharmacology, 6, Miklukho-Maclaya Str., Moscow, 117198;

deputy chief physician, 10, Pestsovaya St., Moscow, 127015

https://orcid.org/0000-0001-7729-2169БутрановаО. И.ButranovaO. I.

Ольга Игоревна Бутранова, канд. мед. наук, доцент кафедры общей и клинической фармакологии,

ул. Миклухо-Маклая, д. 6, Москва, 117198

Olga I. Butranova, Cand. of Med. Sci., associate professor, department of general and clinical pharmacology, 

6, Miklukho-Maclaya Str., Moscow, 117198

butranova-oi@rudn.ruФГАОУ ВО «Российский университет дружбы народов»; ГБУЗ «Городская клиническая больница № 24» Департамента здравоохранения МосквыРоссияPeoples' Friendship University of Russia; City Clinical Hospital No. 24Russian FederationФГАОУ ВО «Российский университет дружбы народов»РоссияPeoples' Friendship University of RussiaRussian Federation202302072023162166172Copyright © Зырянов С.К., Бутранова О.И., 20232023Зырянов С.К., Бутранова О.И.Zyryanov S.K., Butranova O.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://roj.igb.ru/jour/article/view/1252

В основе симптоматики большинства патологических состояний в офтальмологии лежит воспаление различной степени выраженности. Инструментом его эффективного устранения являются топические глюкокортикостероиды (тГКС), молекулы которых способны активно преодолевать биологические мембраны и вызывать быстрый клинический ответ. Применение тГКС сопровождается широким спектром эффектов, включая побочные, среди которых одним из наиболее значимых является подъем внутриглазного давления. Настоящий обзор посвящен сравнительному анализу профиля эффективности и безопасности различных тГКС, включая «мягкие стероиды». Показана взаимосвязь между строением тГКС, их фармакодинамическими эффектами и возможностью применения при различных глазных заболеваниях.

The symptoms of most pathological conditions in ophthalmology are based on inflammations of varying severity. Valuable tools against inflammation are topical glucocorticoids (tGCs), whose molecules are able to actively overcome biological membranes and ensure a rapid clinical response. The use of tGCs is accompanied by a wide range of effects, including side effects, a rise in intraocular pressure being one of the most significant ones. The review focuses on a comparative analysis of the efficacy and safety of various tGCs, including “soft steroids”. We show the relationship between the structure of the drugs, their pharmacodynamic effects and the possibility of being used in various eye diseases.

воспалениетопические глюкокортикостероиды«мягкие стероиды»внутриглазное давлениеinflammationtopical glucocorticoidssoft steroidsintraocular pressureReferencesVaru DM, Rhee MK, Akpek EK, et al. Conjunctivitis preferred practice pattern®. Ophthalmology. 2019 Jan;126 (1): 94–169. doi: 10.1016/j.ophtha.2018.10.020Varu DM, Rhee MK, Akpek EK, et al. Conjunctivitis preferred practice pattern®. Ophthalmology. 2019 Jan;126 (1): 94–169. doi: 10.1016/j.ophtha.2018.10.020Lin A, Rhee MK, Akpek EK, et al. Bacterial keratitis preferred practice pattern®. Ophthalmology. 2019; 126 (1): 1–55. doi:10.1016/j.ophtha.2018.10.018Lin A, Rhee MK, Akpek EK, et al. Bacterial keratitis preferred practice pattern®. Ophthalmology. 2019; 126 (1): 1–55. doi:10.1016/j.ophtha.2018.10.018Ghadiri N, Reekie IR, Gordon I, et al. Systematic review of clinical practice guidelines for uveitis. BMJ Open Ophthalmology. 2023; 8: e001091. doi: 10.1136/bmjophth-2022-001091Ghadiri N, Reekie IR, Gordon I, et al. Systematic review of clinical practice guidelines for uveitis. BMJ Open Ophthalmology. 2023; 8: e001091. doi: 10.1136/bmjophth-2022-001091De Loof H, De Win E, Moens N, et al. Overprescribing of topical ocular corticosteroids and antibiotics in out-of-hours primary care in Belgium. Drug Healthc Patient Saf. 2021; 13: 229–32. doi: 10.2147/DHPS.S339141De Loof H, De Win E, Moens N, et al. Overprescribing of topical ocular corticosteroids and antibiotics in out-of-hours primary care in Belgium. Drug Healthc Patient Saf. 2021; 13: 229–32. doi: 10.2147/DHPS.S339141Khoo P, Cabrera-Aguas M, Watson SL. Topical steroids as adjunctive therapy for bacterial keratitis: Evidence from a retrospective case series of 313 cases. Asia Pac J Ophthalmol (Phila). 2020; 9 (5): 398–403. doi:10.1097/APO.0000000000000320Khoo P, Cabrera-Aguas M, Watson SL. Topical steroids as adjunctive therapy for bacterial keratitis: Evidence from a retrospective case series of 313 cases. Asia Pac J Ophthalmol (Phila). 2020; 9 (5): 398–403. doi:10.1097/APO.0000000000000320Valladales-Restrepo LF, Machado-Duque ME, Gaviria-Mendoza A, et al. Indication-prescription study for the management of conjunctivitis in a Colombian population. Int Ophthalmol. 2023; 43 (1): 83–93. doi: 10.1007/s10792-022-02390-7Valladales-Restrepo LF, Machado-Duque ME, Gaviria-Mendoza A, et al. Indication-prescription study for the management of conjunctivitis in a Colombian population. Int Ophthalmol. 2023; 43 (1): 83–93. doi: 10.1007/s10792-022-02390-7Shekhawat NS, Shtein RM, Blachley TS, Stein JD. Antibiotic prescription fills for acute conjunctivitis among enrollees in a large United States managed care network. Ophthalmology. 2017; 124 (8): 1099–107. doi: 10.1016/j.ophtha.2017.04.034Shekhawat NS, Shtein RM, Blachley TS, Stein JD. Antibiotic prescription fills for acute conjunctivitis among enrollees in a large United States managed care network. Ophthalmology. 2017; 124 (8): 1099–107. doi: 10.1016/j.ophtha.2017.04.034Henderson LA, Zurakowski D, Angeles-Han ST, et al. Childhood Arthritis And Rheumatology Research Alliance (CARRA) registry investigators. Medication use in juvenile uveitis patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance Registry. Pediatr Rheumatol Online J. 2016; 14 (1): 9. doi: 10.1186/s12969-016-0069-5Henderson LA, Zurakowski D, Angeles-Han ST, et al. Childhood Arthritis And Rheumatology Research Alliance (CARRA) registry investigators. Medication use in juvenile uveitis patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance Registry. Pediatr Rheumatol Online J. 2016; 14 (1): 9. doi: 10.1186/s12969-016-0069-5Prinz J, Maffulli N, Fuest M, et al. Efficacy of topical administration of corticosteroids for the management of dry eye disease: Systematic review and meta-analysis. Life. 2022; 12 (11): 1932. https://doi.org/10.3390/life12111932Prinz J, Maffulli N, Fuest M, et al. Efficacy of topical administration of corticosteroids for the management of dry eye disease: Systematic review and meta-analysis. Life. 2022; 12 (11): 1932. https://doi.org/10.3390/life12111932Liu SH, Saldanha IJ, Abraham AG, et al. Topical corticosteroids for dry eye. Cochrane Database Syst Rev. 2022; 10(10): CD015070. doi: 10.1002/14651858.CD015070.pub2Liu SH, Saldanha IJ, Abraham AG, et al. Topical corticosteroids for dry eye. Cochrane Database Syst Rev. 2022; 10(10): CD015070. doi: 10.1002/14651858.CD015070.pub2Ling J, Chan BC, Tsang MS, et al. Current advances in mechanisms and treatment of dry eye disease: Toward anti-inflammatory and immunomodulatory therapy and traditional chinese medicine. Front Med (Lausanne). 2022; 8: 815075. doi: 10.3389/fmed.2021.815075Ling J, Chan BC, Tsang MS, et al. Current advances in mechanisms and treatment of dry eye disease: Toward anti-inflammatory and immunomodulatory therapy and traditional chinese medicine. Front Med (Lausanne). 2022; 8: 815075. doi: 10.3389/fmed.2021.815075Holland EJ, Fingeret M, Mah FS. Use of topical steroids in conjunctivitis: A review of the evidence. Cornea. 2019; 38(8): 1062-7. doi: 10.1097/ICO.0000000000001982Holland EJ, Fingeret M, Mah FS. Use of topical steroids in conjunctivitis: A review of the evidence. Cornea. 2019; 38(8): 1062-7. doi: 10.1097/ICO.0000000000001982Chang YS, Weng SF, Wang JJ, Jan RL. Temporal association between topical ophthalmic corticosteroid and the risk of central serous chorioretinopathy. Int J Environ Res Public Health. 2020; 17 (24): 9455. doi:10.3390/ijerph17249455Chang YS, Weng SF, Wang JJ, Jan RL. Temporal association between topical ophthalmic corticosteroid and the risk of central serous chorioretinopathy. Int J Environ Res Public Health. 2020; 17 (24): 9455. doi:10.3390/ijerph17249455Thorne JE, Woreta FA, Dunn JP, Jabs DA. Risk of cataract development among children with juvenile idiopathic arthritis-related uveitis treated with topical corticosteroids. Ophthalmology. 2010; 117 (7): 1436–41. doi: 10.1016/j.ophtha.2009.12.003Thorne JE, Woreta FA, Dunn JP, Jabs DA. Risk of cataract development among children with juvenile idiopathic arthritis-related uveitis treated with topical corticosteroids. Ophthalmology. 2010; 117 (7): 1436–41. doi: 10.1016/j.ophtha.2009.12.003Zhao L, Sun YJ, Pan ZQ. Topical steroids and antibiotics for adult blepharokeratoconjunctivitis (BKC): A Meta-analysis of randomized clinical trials. J Ophthalmol. 2021; 2021: 3467620. doi:10.1155/2021/3467620Zhao L, Sun YJ, Pan ZQ. Topical steroids and antibiotics for adult blepharokeratoconjunctivitis (BKC): A Meta-analysis of randomized clinical trials. J Ophthalmol. 2021; 2021: 3467620. doi:10.1155/2021/3467620Dey KK, Ghosh M. Understanding the structure and dynamics of antiinflammatory corticosteroid dexamethasone by solid state NMR spectroscopy. RSC Adv. 2020; 10 (61): 37564–75. doi: 10.1039/d0ra05474gDey KK, Ghosh M. Understanding the structure and dynamics of antiinflammatory corticosteroid dexamethasone by solid state NMR spectroscopy. RSC Adv. 2020; 10 (61): 37564–75. doi: 10.1039/d0ra05474gЗырянов С.К., Бутранова О.И. Топические глюкокортикостероиды: эффективность и безопасность в гинекологии. Акушерство и гинекология. 2021; 5: 166–72. doi: 10.18565/aig.2021.5.166-172Zyryanov S.K., Butranova O.I. Topical glucocorticosteroids: efficacy and safety in gynecology. Obstetrics and gynecology. 2021; 5: 166–72 (In Russ.). doi: 10.18565/aig.2021.5.166-172Onyimba CU, Vijapurapu N, Curnow SJ, et al. Characterisation of the prereceptor regulation of glucocorticoids in the anterior segment of the rabbit eye. J Endocrinol. 2006; 190 (2): 483–93. doi: 10.1677/joe.1.06840Onyimba CU, Vijapurapu N, Curnow SJ, et al. Characterisation of the prereceptor regulation of glucocorticoids in the anterior segment of the rabbit eye. J Endocrinol. 2006; 190 (2): 483–93. doi: 10.1677/joe.1.06840Sulaiman RS, Kadmiel M, Cidlowski JA. Glucocorticoid receptor signaling in the eye. Steroids. 2018; 133: 60–6. doi: 10.1016/j.steroids.2017.11.002Sulaiman RS, Kadmiel M, Cidlowski JA. Glucocorticoid receptor signaling in the eye. Steroids. 2018; 133: 60–6. doi: 10.1016/j.steroids.2017.11.002Dismuke WM, Klingeborn M, Stamer WD. Mechanism of fibronectin binding to human trabecular meshwork exosomes and its modulation by dexamethasone. PLoS One. 2016 Oct; 11 (10): e0165326. doi: 10.1371/journal.pone.0165326Dismuke WM, Klingeborn M, Stamer WD. Mechanism of fibronectin binding to human trabecular meshwork exosomes and its modulation by dexamethasone. PLoS One. 2016 Oct; 11 (10): e0165326. doi: 10.1371/journal.pone.0165326Jain A, Wordinger RJ, Yorio T, Clark AF. Role of the alternatively spliced glucocorticoid receptor isoform GRβ in steroid responsiveness and glaucoma. J Ocul Pharmacol Ther.; 30 (2–3): 121–7. doi: 10.1089/jop.2013.0239Jain A, Wordinger RJ, Yorio T, Clark AF. Role of the alternatively spliced glucocorticoid receptor isoform GRβ in steroid responsiveness and glaucoma. J Ocul Pharmacol Ther.; 30 (2–3): 121–7. doi: 10.1089/jop.2013.0239Kathirvel K, Haribalaganesh R, Krishnadas R, et al. A comparative genomewide transcriptome analysis of glucocorticoid responder and non-responder primary human trabecular meshwork cells. Genes (Basel). 2022 ; 13 (5): 882. doi: 10.3390/genes13050882Kathirvel K, Haribalaganesh R, Krishnadas R, et al. A comparative genomewide transcriptome analysis of glucocorticoid responder and non-responder primary human trabecular meshwork cells. Genes (Basel). 2022 ; 13 (5): 882. doi: 10.3390/genes13050882Caramori G, Mumby S, Girbino G, Chung KF, Adcock IM. Corticosteroids. Nijkamp and Parnham's Principles of Immunopharmacology. 2019: 661–88. doi: 10.1007/978-3-030-10811-3_32Caramori G, Mumby S, Girbino G, Chung KF, Adcock IM. Corticosteroids. Nijkamp and Parnham's Principles of Immunopharmacology. 2019: 661–88. doi: 10.1007/978-3-030-10811-3_32Cutolo CA, Barabino S, Bonzano C, Traverso CE. The use of topical corticosteroids for treatment of dry eye syndrome. Ocul Immunol Inflamm. 2019; 27 (2): 266–75. doi: 10.1080/09273948.2017.1341988Cutolo CA, Barabino S, Bonzano C, Traverso CE. The use of topical corticosteroids for treatment of dry eye syndrome. Ocul Immunol Inflamm. 2019; 27 (2): 266–75. doi: 10.1080/09273948.2017.1341988Jinagal J, Gupta PC, Pilania RK, Ram J. Systemic toxicity of topical corticosteroids. Indian J Ophthalmol. 2019; 67 (4): 559–61. doi: 10.4103/ijo.IJO_1091_18Jinagal J, Gupta PC, Pilania RK, Ram J. Systemic toxicity of topical corticosteroids. Indian J Ophthalmol. 2019; 67 (4): 559–61. doi: 10.4103/ijo.IJO_1091_18Vajaranant TS, Price MO, Price FW, et al. Visual acuity and intraocular pressure after Descemet's stripping endothelial keratoplasty in eyes with and without preexisting glaucoma. Ophthalmology. 2009; 116 (9): 1644–50. doi: 10.1016/j.ophtha.2009.05.034Vajaranant TS, Price MO, Price FW, et al. Visual acuity and intraocular pressure after Descemet's stripping endothelial keratoplasty in eyes with and without preexisting glaucoma. Ophthalmology. 2009; 116 (9): 1644–50. doi: 10.1016/j.ophtha.2009.05.034Yakin M, Kumar A, Kodati S, Jones L, Sen HN. Risk of elevated intraocular pressure with Difluprednate in patients with non-infectious uveitis. Am J Ophthalmol. 2022; 240: 232–8. doi: 10.1016/j.ajo.2022.03.026Yakin M, Kumar A, Kodati S, Jones L, Sen HN. Risk of elevated intraocular pressure with Difluprednate in patients with non-infectious uveitis. Am J Ophthalmol. 2022; 240: 232–8. doi: 10.1016/j.ajo.2022.03.026Sen P, Jain S, Mohan A, et al. Pattern of steroid misuse in vernal keratoconjunctivitis resulting in steroid induced glaucoma and visual disability in Indian rural population: An important public health problem in pediatric age group. Indian J Ophthalmol. 2019; 67 (10): 1650–5. doi: 10.4103/ijo.IJO_2143_18Sen P, Jain S, Mohan A, et al. Pattern of steroid misuse in vernal keratoconjunctivitis resulting in steroid induced glaucoma and visual disability in Indian rural population: An important public health problem in pediatric age group. Indian J Ophthalmol. 2019; 67 (10): 1650–5. doi: 10.4103/ijo.IJO_2143_18Ugalahi MO, Ibukun FA, Olusanya BA, Baiyeroju AM. Intraocular pressure elevation following the use of topical dexamethasone ointment after squint surgery. J West Afr Coll Surg. 2022; 12 (1): 70–5. doi: 10.4103/jwas.jwas_26_22Ugalahi MO, Ibukun FA, Olusanya BA, Baiyeroju AM. Intraocular pressure elevation following the use of topical dexamethasone ointment after squint surgery. J West Afr Coll Surg. 2022; 12 (1): 70–5. doi: 10.4103/jwas.jwas_26_22Price MO, Feng MT, Scanameo A, Price FW Jr. Loteprednol Etabonate 0.5% Gel Vs. Prednisolone Acetate 1 % Solution after descemet membrane endothelial keratoplasty: Prospective randomized trial. Cornea. 2015; 34 (8): 853–8. doi: 10.1097/ICO.0000000000000475Price MO, Feng MT, Scanameo A, Price FW Jr. Loteprednol Etabonate 0.5% Gel Vs. Prednisolone Acetate 1 % Solution after descemet membrane endothelial keratoplasty: Prospective randomized trial. Cornea. 2015; 34 (8): 853–8. doi: 10.1097/ICO.0000000000000475Price MO, Price FW Jr, Kruse FE, Bachmann BO, Tourtas T. Randomized comparison of topical prednisolone acetate 1% versus fluorometholone 0.1 % in the first year after descemet membrane endothelial keratoplasty. Cornea. 2014; 33 (9): 880–6. doi: 10.1097/ICO.0000000000000206Price MO, Price FW Jr, Kruse FE, Bachmann BO, Tourtas T. Randomized comparison of topical prednisolone acetate 1% versus fluorometholone 0.1 % in the first year after descemet membrane endothelial keratoplasty. Cornea. 2014; 33 (9): 880–6. doi: 10.1097/ICO.0000000000000206Pleyer U, Ursell PG, Rama P. Intraocular pressure effects of common topical steroids for post-cataract inflammation: are they all the same? Ophthalmol Ther. 2013; 2 (2): 55–72. doi: 10.1007/s40123-013-0020-5Pleyer U, Ursell PG, Rama P. Intraocular pressure effects of common topical steroids for post-cataract inflammation: are they all the same? Ophthalmol Ther. 2013; 2 (2): 55–72. doi: 10.1007/s40123-013-0020-5Musleh MG, Bokre D, Dahlmann-Noor AH. Risk of intraocular pressure elevation after topical steroids in children and adults: A systematic review. Eur J Ophthalmol. 2020; 30 (5): 856–66. doi: 10.1177/1120672119885050Musleh MG, Bokre D, Dahlmann-Noor AH. Risk of intraocular pressure elevation after topical steroids in children and adults: A systematic review. Eur J Ophthalmol. 2020; 30 (5): 856–66. doi: 10.1177/1120672119885050Morrison E, Archer DB. Effect of fluorometholone (FML) on the intraocular pressure of corticosteroid responders. Br J Ophthalmol. 1984; 68 (8): 581–4. doi: 10.1136/bjo.68.8.581Morrison E, Archer DB. Effect of fluorometholone (FML) on the intraocular pressure of corticosteroid responders. Br J Ophthalmol. 1984; 68 (8): 581–4. doi: 10.1136/bjo.68.8.581Akingbehin AO. Comparative study of the intraocular pressure effects of fluorometholone 0.1% versus dexamethasone 0.1 %. Br J Ophthalmol. 1983; 67 (10): 661–3. doi: 10.1136/bjo.67.10.661Akingbehin AO. Comparative study of the intraocular pressure effects of fluorometholone 0.1% versus dexamethasone 0.1 %. Br J Ophthalmol. 1983; 67 (10): 661–3. doi: 10.1136/bjo.67.10.661Al Hanaineh AT, Hassanein DH, Abdelbaky SH, El Zawahry OM. Steroidinduced ocular hypertension in the pediatric age group. Eur J Ophthalmol. 2018; 28 (4): 372–7. doi: 10.1177/1120672118757434Al Hanaineh AT, Hassanein DH, Abdelbaky SH, El Zawahry OM. Steroidinduced ocular hypertension in the pediatric age group. Eur J Ophthalmol. 2018; 28 (4): 372–7. doi: 10.1177/1120672118757434Kempen JH, Tekle-Haimanot R, Hunduma L, et al. Fluorometholone 0.1 % as ancillary therapy for trachomatous trichiasis surgery: Randomized clinical trial. Am J Ophthalmol. 2019; 197: 145-55. doi: 10.1016/j.ajo.2018.09.017Kempen JH, Tekle-Haimanot R, Hunduma L, et al. Fluorometholone 0.1 % as ancillary therapy for trachomatous trichiasis surgery: Randomized clinical trial. Am J Ophthalmol. 2019; 197: 145-55. doi: 10.1016/j.ajo.2018.09.017Fakhraie G, Vahedian Z, Zarei R, et al. Intraocular pressure trend following myopic photorefractive keratectomy. Int Ophthalmol. 2022; 42 (8): 2313–21. doi: 10.1007/s10792-022-02228-2Fakhraie G, Vahedian Z, Zarei R, et al. Intraocular pressure trend following myopic photorefractive keratectomy. Int Ophthalmol. 2022; 42 (8): 2313–21. doi: 10.1007/s10792-022-02228-2Razmjoo H, Mikaniki M, Peyman A, et al. Clinical efficacy of Fluorometholone versus Loteprednol eye drops after photorefractive keratectomy: A triple-blinded randomized controlled trial. Eur J Ophthalmol. 2023; 33 (1): 595–601. doi: 10.1177/11206721221106142Razmjoo H, Mikaniki M, Peyman A, et al. Clinical efficacy of Fluorometholone versus Loteprednol eye drops after photorefractive keratectomy: A triple-blinded randomized controlled trial. Eur J Ophthalmol. 2023; 33 (1): 595–601. doi: 10.1177/11206721221106142Karimian F, Faramarzi A, Fekri S, et al. Comparison of Loteprednol with Fluorometholone after myopic photorefractive keratectomy. J Ophthalmic Vis Res. 2017; 12 (1): 11–6. doi: 10.4103/2008-322X.200161Karimian F, Faramarzi A, Fekri S, et al. Comparison of Loteprednol with Fluorometholone after myopic photorefractive keratectomy. J Ophthalmic Vis Res. 2017; 12 (1): 11–6. doi: 10.4103/2008-322X.200161Shokoohi-Rad S, Daneshvar R, Jafarian-Shahri M, Rajaee P. Comparison between Betamethasone, Fluorometholone and Loteprednol Etabonate on intraocular pressure in patients after keratorefractive surgery. J Curr Ophthalmol. 2017; 30 (2): 130–5. doi: 10.1016/j.joco.2017.11.008Shokoohi-Rad S, Daneshvar R, Jafarian-Shahri M, Rajaee P. Comparison between Betamethasone, Fluorometholone and Loteprednol Etabonate on intraocular pressure in patients after keratorefractive surgery. J Curr Ophthalmol. 2017; 30 (2): 130–5. doi: 10.1016/j.joco.2017.11.008Yoo YJ, Yang HK, Hwang JM. Efficacy and safety of Loteprednol 0.5% and Fluorometholone 0.1% after strabismus surgery in children. J Ocul Pharmacol Ther. 2018; 34 (6): 468–76. doi: 10.1089/jop.2017.0145Yoo YJ, Yang HK, Hwang JM. Efficacy and safety of Loteprednol 0.5% and Fluorometholone 0.1% after strabismus surgery in children. J Ocul Pharmacol Ther. 2018; 34 (6): 468–76. doi: 10.1089/jop.2017.0145Raj A, Salvador-Culla B, Anwar H, et al. Long-term outcomes on de novo ocular hypertensive response to topical corticosteroids after corneal transplantation. Cornea. 2020; 39 (1): 45–51. doi: 10.1097/ICO.0000000000002142Raj A, Salvador-Culla B, Anwar H, et al. Long-term outcomes on de novo ocular hypertensive response to topical corticosteroids after corneal transplantation. Cornea. 2020; 39 (1): 45–51. doi: 10.1097/ICO.0000000000002142Mastropasqua L, Brescia L, D'Arcangelo F, et al. Topical steroids and glaucoma filtration surgery outcomes: An in vivo confocal study of the conjunctiva. J Clin Med. 2022; 11 (14): 3959. doi: 10.3390/jcm11143959Mastropasqua L, Brescia L, D'Arcangelo F, et al. Topical steroids and glaucoma filtration surgery outcomes: An in vivo confocal study of the conjunctiva. J Clin Med. 2022; 11 (14): 3959. doi: 10.3390/jcm11143959Chen PQ, Han XM, Zhu YN, Xu J. Comparison of the anti-inflammatory effects of fluorometholone 0.1 % combined with levofloxacin 0.5 % and tobramycin/ dexamethasone eye drops after cataract surgery. Int J Ophthalmol. 2016; 9 (11): 1619–23. doi: 10.18240/ijo.2016.11.13Chen PQ, Han XM, Zhu YN, Xu J. Comparison of the anti-inflammatory effects of fluorometholone 0.1 % combined with levofloxacin 0.5 % and tobramycin/ dexamethasone eye drops after cataract surgery. Int J Ophthalmol. 2016; 9 (11): 1619–23. doi: 10.18240/ijo.2016.11.13Balasubramaniam B, Chong YJ, Azzopardi M, Logeswaran A, Denniston AK. Topical anti-inflammatory agents for non-infectious uveitis: current treatment and perspectives. J Inflamm Res. 2022; 15: 6439–51. doi: 10.2147/JIR.S288294Balasubramaniam B, Chong YJ, Azzopardi M, Logeswaran A, Denniston AK. Topical anti-inflammatory agents for non-infectious uveitis: current treatment and perspectives. J Inflamm Res. 2022; 15: 6439–51. doi: 10.2147/JIR.S288294Samudre SS, Lattanzio FA Jr, Williams PB, Sheppard JD Jr. Comparison of topical steroids for acute anterior uveitis. J Ocul Pharmacol Ther. 2004; 20 (6): 533–47. doi: 10.1089/jop.2004.20.533Samudre SS, Lattanzio FA Jr, Williams PB, Sheppard JD Jr. Comparison of topical steroids for acute anterior uveitis. J Ocul Pharmacol Ther. 2004; 20 (6): 533–47. doi: 10.1089/jop.2004.20.533Knutsson KA, Genovese PN, Paganoni G, et al. Evaluation of a post-operative therapy protocol after epithelium-off corneal cross-linking in patients affected by keratoconus. J Clin Med. 2022; 11 (23): 7093. doi: 10.3390/jcm11237093Knutsson KA, Genovese PN, Paganoni G, et al. Evaluation of a post-operative therapy protocol after epithelium-off corneal cross-linking in patients affected by keratoconus. J Clin Med. 2022; 11 (23): 7093. doi: 10.3390/jcm11237093Майчук Д.Ю., Тарханова А.А. Преимущества «мягких стероидов» в лечении воспалительных заболеваний глаз. Обзор. Офтальмология. 2021; 18 (4): 778–83. doi: 10.18008/1816-5095-2021-4-778-783Maychuk D.Yu., Tarkhanova A.A. Advantages of “soft steroids” in the treatment of inflammatory eye diseases. Оverview. Ophthalmology in Russia. 2021; 18 (4): 778–83 (In Russ.). doi: 10.18008/1816-5095-2021-4-778-783Alwadani S. Safety and efficacy of sodium cromoglycate-fluorometholone fixed combination eye drops in allergic conjunctivitis. Saudi J Ophthalmol. 2022; 36 (1): 107–12. doi: 10.4103/sjopt.sjopt_208_21Alwadani S. Safety and efficacy of sodium cromoglycate-fluorometholone fixed combination eye drops in allergic conjunctivitis. Saudi J Ophthalmol. 2022; 36 (1): 107–12. doi: 10.4103/sjopt.sjopt_208_21Wu LQ, Chen X, Lou H, Cheng JW, Wei RL. Loteprednol etabonate in the treatment of allergic conjunctivitis: a meta-analysis. Curr Med Res Opin. 2015; 31 (8): 1509–18. doi: 10.1185/03007995.2015.1058250Wu LQ, Chen X, Lou H, Cheng JW, Wei RL. Loteprednol etabonate in the treatment of allergic conjunctivitis: a meta-analysis. Curr Med Res Opin. 2015; 31 (8): 1509–18. doi: 10.1185/03007995.2015.1058250Taniguchi J, Sharma A. Fluorometholone modulates gene expression of ocular surface mucins. Acta Ophthalmol. 2019; 97 (8): e1082-e8. doi: 10.1111/aos.14113Taniguchi J, Sharma A. Fluorometholone modulates gene expression of ocular surface mucins. Acta Ophthalmol. 2019; 97 (8): e1082-e8. doi: 10.1111/aos.14113Milner MS, Beckman KA, Luchs JI, et al. Dysfunctional tear syndrome: dry eye disease and associated tear film disorders - new strategies for diagnosis and treatment. Curr Opin Ophthalmol. 2017; 27 (Suppl 1): 3–47. doi: 10.1097/01.icu.0000512373.81749.b7Milner MS, Beckman KA, Luchs JI, et al. Dysfunctional tear syndrome: dry eye disease and associated tear film disorders - new strategies for diagnosis and treatment. Curr Opin Ophthalmol. 2017; 27 (Suppl 1): 3–47. doi: 10.1097/01.icu.0000512373.81749.b7Pinto-Fraga J, López-Miguel A, González-García MJ, et al. Topical fluorometholone protects the ocular surface of dry eye patients from desiccating stress: A randomized controlled clinical trial. Ophthalmology. 2016; 123 (1): 141–53. doi: 10.1016/j.ophtha.2015.09.029Pinto-Fraga J, López-Miguel A, González-García MJ, et al. Topical fluorometholone protects the ocular surface of dry eye patients from desiccating stress: A randomized controlled clinical trial. Ophthalmology. 2016; 123 (1): 141–53. doi: 10.1016/j.ophtha.2015.09.029Gao Y, Liu R, Liu Y, et al. Optical quality in patients with dry eye before and after treatment. Clin Exp Optom. 2021; 104 (1): 101–6. doi: 10.1111/cxo.13111Gao Y, Liu R, Liu Y, et al. Optical quality in patients with dry eye before and after treatment. Clin Exp Optom. 2021; 104 (1): 101–6. doi: 10.1111/cxo.13111Yang CQ, Sun W, Gu YS. A clinical study of the efficacy of topical corticosteroids on dry eye. J Zhejiang Univ Sci B. 2006; 7 (8): 675–8. doi: 10.1631/jzus.2006.B0675Yang CQ, Sun W, Gu YS. A clinical study of the efficacy of topical corticosteroids on dry eye. J Zhejiang Univ Sci B. 2006; 7 (8): 675–8. doi: 10.1631/jzus.2006.B0675Nättinen J, Jylhä A, Aapola U, et al. Topical fluorometholone treatment and desiccating stress change inflammatory protein expression in tears. Ocul Surf. 2018; 16 (1): 84–92. doi: 10.1016/j.jtos.2017.09.003Nättinen J, Jylhä A, Aapola U, et al. Topical fluorometholone treatment and desiccating stress change inflammatory protein expression in tears. Ocul Surf. 2018; 16 (1): 84–92. doi: 10.1016/j.jtos.2017.09.003Lin T, Gong L. Topical fluorometholone treatment for ocular dryness in patients with Sjögren syndrome: a randomized clinical trial in China. Medicine (Baltimore). 2015; 94 (7): e551. doi: 10.1097/MD.0000000000000551Lin T, Gong L. Topical fluorometholone treatment for ocular dryness in patients with Sjögren syndrome: a randomized clinical trial in China. Medicine (Baltimore). 2015; 94 (7): e551. doi: 10.1097/MD.0000000000000551Zhou X, Wang L, Zhang Z, et al. Fluorometholone inhibits high glucoseinduced cellular senescence in human retinal endothelial cells. Hum Exp Toxicol. 2022 Jan-Dec; 41: 9603271221076107. doi: 10.1177/09603271221076107Zhou X, Wang L, Zhang Z, et al. Fluorometholone inhibits high glucoseinduced cellular senescence in human retinal endothelial cells. Hum Exp Toxicol. 2022 Jan-Dec; 41: 9603271221076107. doi: 10.1177/09603271221076107

The authors declare that there are no conflicts of interest present.