Efficacy of 3% diquafosol combined with azelastine hydrochloride in allergic conjunctivitis patients with dry eye

Purpose: To evaluate the efficacy of a 3% diquafosol combined with azelastine hydrochloride ophthalmic solution in allergic conjunctivitis (AC) patients with dry eye. Methods The sample was composed of 158 eyes of 79 patients diagnosed with AC and dry eye. After enrollment, all subjects received azelastine hydrochloride (twice daily) combined with 3% diquafosol (six times daily) for four weeks. Scores of AC symptoms and signs, ocular surface disease index (OSDI), bulbar conjunctival hyperemia, tear meniscus height (TMH), non-invasive tear film break-up time (NIBUT), corneal fluorescein staining score, tear film break-up time (TBUT) and the Schirmer test were assessed at the baseline and two and four weeks after treatment. Results The symptom score of itching, foreign body sensation, and eye photophobia showed a significant decrease at two and four-week follow-up after treatment compared with baseline (p < 0.001). The eye tearing score showed a significant decrease at four weeks after treatment (p = 0.002). The AC sign score of follicles, conjunctival secretion and conjunctival hyperemia were significantly decreased at two and four weeks after treatment compare with baseline (p < 0.001, p = 0.001, respectively). After two and four weeks treatment, the OSDI score showed significantly decrease compared with baseline (26.53 ± 15.32 vs 17.25 ± 12.49, p < 0.001; 26.53 ± 15.32 vs 10.31 ± 8.54, p < 0.001). TMH, NIBUT and TBUT showed significantly improvement from baseline (TMH, 0.21 ± 0.06 vs 0.28 ± 0.07; 0.21 ± 0.06 vs 0.29 ± 0.07; NIBUT, 7.74 ± 3.35 vs 9.12 ± 3.09; 7.74 ± 3.35 vs 10.60 ± 2.86; TBUT, 3.53 ± 1.18 vs 4.53 ± 1.93; 3.53 ± 1.18 vs 4.53 ± 2.27; all p < 0.001). Conclusion 3% diquafosol combined with azelastine hydrochloride significantly improved subjective symptoms and objective signs in AC patients with dry eye.