Efficacy of Oral Doxycycline in Reducing the Size of Pterygium lesions

Article Information

Title: Efficacy of Oral Doxycycline in Reducing the Size of Pterygium lesions

Authors: Shafaq Rabbani, Amjad Akram, Amer Yaqub, Ammara Ashraf, Fatima Khan

Journal: Pakistan Armed Forces Medical Journal (PAFMJ)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2021-07-01	2022-06-30
Y	2020-07-01	2021-06-30
Y	1900-01-01	2005-06-30

Publisher: Army Medical College, Rawalpindi.

Country: Pakistan

Year: 2022

Volume: 72

Issue: Supplementary 2

Language: English

DOI: 10.51253/pafmj.v72iSUPPL-2.4007

Keywords: DoxycyclinePterygium/pathologyPterygium/drug therapy

Abstract

Objective: To assess the efficacy of oral Doxycycline in reducing the size of pterygium lesions in a Pakistani population
Study Design: Quasi-experimental study.
Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from Sep 2018 and May 2019.
Methodology: Sixty patients above 20 years of age were enrolled in the study. Oral Doxycycline 200m/day was given for thirty consecutive days. Photographs of the lesions were taken at the time of recruitment and at the end of the study for assessment of pterygium size. Difference between pre-treatment and post-treatment size was analysed and comparison was made with age, gender and initial lesion size.
Results: Twenty-two females and thirty-eight males were examined. The mean age of the participants was 48.8 ± 13.8 years. The mean size of the pterygium lesions before commencing the treatment was 12.24 ± 6.28 mm2. The mean size of the lesions after the treatment was 11.24 ± 5.39 mm2. The mean difference size was 1.00 ± 1.62 mm2 (p &lt;0.001). The relative change in size (i.e. post-treatment size divided by pre-treatment size) was 0.94 ± 0.09 which was found to be statistically significant (p&lt;0.001). There was correlation between larger initial lesion size and greater relative reduction in size (r = -0.42, p = 0.001).
Conclusion: The change in the size of pterygium lesions produced by Doxycycline was found to be statistically significant but was not deemed clinically significant. Therefore, oral Doxycycline is not recommended for the treatment of pterygium in our population.

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Research Objective

To assess the efficacy of oral Doxycycline in reducing the size of pterygium lesions in a Pakistani population.

Methodology

Quasi-experimental study involving sixty patients above 20 years of age with primary fleshy pterygium. Patients received oral Doxycycline 200mg/day for thirty consecutive days. Photographs of the lesions were taken before and after treatment to assess size changes. Statistical analysis was performed using Wilcoxon signed ranks test and Spearman correlation.

Methodology Flowchart

                        graph TD
    A["Patient Recruitment >20 years, primary fleshy pterygium"] --> B["Informed Consent"];
    B --> C["Ophthalmic Examination & Photography"];
    C --> D["Prescription: Oral Doxycycline 200mg/day for 30 days"];
    D --> E["Follow-up after 30 days: Re-examination & Photography"];
    E --> F["Data Collection: Pre- and Post-treatment Lesion Size"];
    F --> G["Statistical Analysis: Wilcoxon signed ranks test, Spearman correlation"];
    G --> H["Conclusion: Efficacy Assessment"];

Discussion

Oral Doxycycline showed a statistically significant reduction in pterygium lesion size, particularly in larger lesions. However, this reduction was not considered clinically significant for patients with substantial corneal involvement. The drug was well-tolerated, with most patients reporting subjective improvement in symptoms like redness and foreign body sensation, possibly due to reduced vascularity. The study acknowledges limitations including the short treatment duration and the focus on primary pterygia.

Key Findings

The mean size of pterygium lesions decreased from 12.24 ± 6.28 mm² to 11.24 ± 5.39 mm², with a mean difference of 1.00 ± 1.62 mm² (p <0.001). The relative change in size was 0.94 ± 0.09 (p<0.001). A correlation was found between larger initial lesion size and greater relative reduction in size (r = -0.42, p = 0.001). While statistically significant, the change was not deemed clinically significant.

Conclusion

The reduction in pterygium lesion size achieved with oral Doxycycline was statistically significant but not clinically significant. Therefore, oral Doxycycline is not recommended for the treatment of pterygium in the studied population.

Fact Check

1. Sample Size: 60 patients completed the study.
2. Treatment Duration: Oral Doxycycline was administered for 30 consecutive days.
3. Statistical Significance: The mean difference in lesion size (1.00 ± 1.62 mm²) and the relative change in size (0.94 ± 0.09) were found to be statistically significant (p <0.001).

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