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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 69 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. |