الفهرس 
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Abstract
Inflammatory eye disease encompasses a wide range of clinical phenotypes.
Uveitis is a group of inflammatory conditions affecting the eye. It is a major cause of
blindness globally, with an estimated prevalence of 38 to 114.5 per 100,000
populations. Uveitis can occur in any age, but it has a tendency to affect the workingage group, thus having a high socio-economic impact.
Uveitis can be classified anatomically into either anterior, intermediate and
posterior uveitis or panuveitis; and as acute or chronic disease, depending on whether it
lasts more or less than 3 months in duration
Endogenous anterior uveitis (EAU) is a form of uveitis that is not directly
caused by an infectious pathogen. It is characterized by intraocular inflammation of the
uveal structures anterior to the middle of the vitreous cavity, including iritis,
iridocyclitis, and anterior cyclitis.
Anterior uveitis is characterized by an inflammatory cellular infiltrate. The
anterior chamber of the eye is filled with an optically clear aqueous fluid, allowing the
practitioner to clearly see infiltrating leukocytes that are counted and scored in
accordance with standardized grading systems. The grading of cellular reaction in the
anterior chamber helps in the assessment of the severity of anterior uveitis. Grading is
useful in determining the patients’ response to therapy as well as long-term monitoring.
Corticosteroids are the mainstay of treatment of all types of non-infectious
uveitis for more than 60 years. Anterior uveitis is treated to control symptoms of pain,
photophobia, and redness, and to reduce complications. Topical corticosteroids
penetrate well into the AC and can be given very frequently when the uveitis is active
and tapered as the inflammation is controlled. These drugs are inexpensive, fast-acting,
and potent properties that have made them the first line of therapy for virtually all
patients with non-infectious ocular inflammatory disease.
The most widely prescribed strong topical corticosteroid is prednisolone acetate
1%. While it controls inflammation effectively, it has not been shown to consistently
address pain and discomfort in a large clinical trial
Difluprednate is a prednisolone acetate derivative that is augmented by two
fluorinations at carbons 6 and 9, a butyrate group at carbon 17, and an acetic acid group
at carbon 21. Relative to its parent molecule, the fluorinations enhance the
corticosteroid potency of difluprednate, the butyric acid augments anti-inflammatory
activity, and the acetic acid increases penetration.
The aim of this study was to compare topical difluprednate 0.05% and
prednisolone acetate 1% in the management of active anterior uveitis regarding their
efficacy and safety.
A total of 48 eyes of 44 patients participated in this study. All were diagnosed
with acute anterior uveitis. Half of the patients received difluprednate 0.05% eye drops
four times daily for two weeks. The other half of patients received prednisolone acetate
1% eight times per day for 2 weeks. Dose tapering was done for 2 weeks. Then follow
up for all patients done at day 35.Summary
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As regarding cell grading at day 14, this study showed that all cases were
detected to have grade 0 in both groups after 2 weeks of intervention. It was noticed that
the change in the cells was higher among Difluprednate group when compared to the
prednisone group in this study with no significant difference between the studied groups
regarding changes in cell count at different day’s measurements.
As regarding AC flare grading it was noticed that twenty-two eyes (22/42; 91.7%)
in the difluprednate group were of grade 0 compared to 66.7% (16/24; 66.7%) in
prednisolone group at day 14th of intervention. This study showed that there was a nonsignificant difference between the two groups as regarding changes in flare grading at
different days.
Regarding IOP this study showed the change of IOP was higher among
prednisolone group at 7th and 14th days when compared to difluprednate group except
at day 3 where IOP change was the same between the two groups but the difference was
statistically non-significant.
Regarding VA this study showed that there were non-significant differences
between the two studied groups as regarding change in visual acuity from baseline to
day 21 visits.