Euphrasia Eye Drops in Preterm Neonates With Ocular Discharge: A Randomized Double-Blind Placebo-Controlled Trial

Delphine Meier-Girard; Gisa Gerstenberg; Liliane Stoffel; Therese Kohler; Sabine D Klein; Marco Eschenmoser; Vera Ruth Mitter; Mathias Nelle; Ursula Wolf

doi:10.3389/fped.2020.00449

Euphrasia Eye Drops in Preterm Neonates With Ocular Discharge: A Randomized Double-Blind Placebo-Controlled Trial

Front Pediatr. 2020 Aug 11:8:449. doi: 10.3389/fped.2020.00449. eCollection 2020.

Authors

Delphine Meier-Girard¹, Gisa Gerstenberg¹, Liliane Stoffel², Therese Kohler², Sabine D Klein¹, Marco Eschenmoser³, Vera Ruth Mitter⁴, Mathias Nelle⁵, Ursula Wolf¹

Affiliations

¹ Anthroposophically Extended Medicine, Institute of Complementary and Integrative Medicine, University of Bern, Bern, Switzerland.
² Department of Neonatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
³ Department of Pharmacy, Hospital of Freiburg, Freiburg, Switzerland.
⁴ Department of Obstetrics and Gynecology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁵ Neonatology Division, University Hospital of Zurich, Zurich, Switzerland.

Abstract

Aim: To investigate whether the early administration of Euphrasia eye drops® in preterm neonates presenting with ocular discharge fosters the resolution of the ocular discharge and reduces the need for topical antibiotic therapy, as compared to placebo. Methods: We conducted a randomized double-blind placebo-controlled trial at the University Children's Hospital Bern, Switzerland. Preterm neonates with white, yellow, or green ocular discharge were included. Infants were randomly assigned (1:1) to the Euphrasia arm (Euphrasia eye drops®, Weleda AG, Arlesheim) or the placebo arm (NaCl 0.9%). Euphrasia or placebo was administrated at a dose of one drop in each eye four times a day over a period of 96 h. The primary outcome was the treatment success, defined as no ocular discharge at 96 h and no use of topical antibiotic therapy during the 96-h intervention. Results: A total of 114 neonates were screened and 84 were randomized. Among neonates in the Euphrasia arm, 22 (55.0%) achieved our primary outcome compared to 21 (51.2%) in the placebo arm (p = 0.85). In the Euphrasia arm, time to resolution of reddening tended to fall within the shorter bracket of 24 to 48 h (24 (92.3%) vs. 12 (80.0%) in the placebo arm, p = 0.34) and relapse or first signs of reddening during the 96-h intervention tended to be lower [3 (7.9%) eyes vs. 8 (18.2%) eyes in the placebo arm, p = 0.17]. Tearing at 96 h tended to be lower in the Euphrasia arm [5 (12.8%) eyes in the Euphrasia arm vs. 12 (27.3%) eyes in the placebo arm, p = 0.10]. Discussion: Euphrasia did not significantly improve treatment success, defined as no ocular discharge at 96 h and no use of topical antibiotic therapy during the 96-h intervention. However, results suggest that Euphrasia may be of benefit for symptoms such as reddening and tearing, and thus improve the comfort of patients. Trial Registration: The trial is registered at the US National Institutes of Health (ClinicalTrials.gov) NCT04122300 and at the portal for human research in Switzerland SNCTP000003490.

Keywords: Euphrasia drops; complementary medicine; congenital nasolacrimal duct obstruction; ocular discharge; preterm neonate.

Associated data

ClinicalTrials.gov/NCT04122300