ASCRS, San Francisco, CA, April 3-8, 2009

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ASCRS, San Francisco, CA, April 3-8, 2009 Use of Azithromycin Ophthalmic Solution in the Treatment of Chronic Mixed Anterior Blepharitis Thomas John, MD (1) Ami A. Shah, BS MBB (2) (1) Clinical Associate Professor, Loyola University at Chicago, Maywood, Illinois, USA (2) Rosalind Franklin University of Medicine & Science/Chicago Medical School, North Chicago, Illinois, USA tjcornea@gmail.com ASCRS, San Francisco, CA, April 3-8, 2009

ASCRS, San Francisco, CA, April 3-8, 2009 Materials & Methods Prospective, open-label study 150 eyes (75 patients) with clinical chronic mixed anterior blepharitis Average age of patients was 65.7 years + 1.86 Patients were treated for either 4 or 8 weeks 33 males and 42 females At the initial visit, all patients underwent a complete slit-lamp examination and the eyelids were evaluated Lids were evaluated for lid closure and blink patterns, apposition of eyelids, lid inflammation, and changes or disorders of the lid margin Patients were instructed to apply azithromycin ophthalmic solution on to their washed, clean index finger or to a clean applicator and then to apply the medication directly to the eyelids of both eyes, rather than using eye drops directly onto the ocular surface OU QHS Both eyes of each patient were treated with azithromycin ophthalmic solution (AzaSite® 1%, Inspire Pharmaceuticals, Durham, NC) or erythromycin ophthalmic ointment These patients were evaluated and treated with: Azithromycin (67 patients, n=134 eyes) Erythromycin (8 patients, n=16) John, T ASCRS, San Francisco, CA, April 3-8, 2009

(Percentage of Lid Margin) ASCRS, San Francisco, CA, April 3-8, 2009 Grading of Chronic Mixed Anterior Blepharitis Grade Collarettes (Height in mm) Ulcerations (Percentage of Lid Margin) Matting Erythema 1 (Trace) < 1 10 < 25 2 (Mild) 1 30 0 – 5 25 – 50 3 (Moderate) 2 50 6 – 10 50 – 75 4 (Severe) > 2 >50 > 10 > 75 Any three criteria/ Upper or Lower Lid Patients with clinical resolution were graded 0 Mixed = Seborrhic and Staphylococcal John, T ASCRS, San Francisco, CA, April 3-8, 2009

ASCRS, San Francisco, CA, April 3-8, 2009 Clinical Resolution by 4 weeks The total clinical resolution after 4 weeks was 98.5% for the AzaSite® treated group and 37.5% for the erythromycin treated group ASCRS, San Francisco, CA, April 3-8, 2009

ASCRS, San Francisco, CA, April 3-8, 2009 Clinical Resolution by 8 weeks The total clinical resolution after 8 weeks was 98.5% for the AzaSite® treated group and 50% for the erythromycin treated group ASCRS, San Francisco, CA, April 3-8, 2009

ASCRS, San Francisco, CA, April 3-8, 2009 Summary In summary, this is the first study showing the clinical efficacy of using azithromycin ophthalmic solution (AzaSite® 1%, Inspire Pharmaceuticals, Durham, NC) directly on the eyelids for the effective treatment of chronic, mixed, anterior Blepharitis, with treatment times as short as 4 weeks John, T ASCRS, San Francisco, CA, April 3-8, 2009