INTRODUCTION: Eye drops made from Euphrasia rostkoviana Hayne have been used in anthroposophical medicine for more than 70 years for the structuring of the fluid organism in the eye, especially in inflammatory and catarrhal conjunctivitis. The aim of this prospective cohort trial was to describe the efficacy and tolerability of these eye drops in a community-based setting. To evaluate these questions, prospective cohort studies are the best method. This enables the investigator to attain real insights as to which treatment administered related to specific results in a specific group of patients.
DESIGN: Prospective, open label, one-armed, multicentered, multinational cohort trial.
SETTING: The trial was carried out in the clinics of 12 experienced anthroposophical general practitioners and ophthalmologists in Germany and Switzerland.
PATIENTS: Patients with inflammatory or catarrhal conjunctivitis, treated with Euphrasia single-dose eye drops were included in the trial.
INTERVENTION: One drop of Euphrasia single-dose eye drops 1-5 times a day was prescribed. The prescription was determined solely by medical therapeutic needs.
OUTCOME MEASURES: Efficacy variables were: redness, swelling, secretion, burning of the conjunctiva, and foreign body sensation. Tolerability variables were: conjunctival reddening, burning of the conjunctiva, foreign body sensation, and veiled vision. All symptoms were given for the right or left eye separately, with degree of severity in relation to baseline after approximately 7 days (+/-3 days; first follow-up examination) and after approximately 14 days (+/-3 days; second follow-up examination). If, after the first follow-up, all symptoms had disappeared, no second follow-up was done.
RESULTS: Sixty-five (65) patients fulfilled the inclusion criteria for the protocol evaluation. A complete recovery was seen in 53 patients (81.5%) and a clear improvement in 11 patients (17.0%). A slight worsening could only be determined in 1 patient in the second week of treatment (1.5%). No serious adverse events were observed during the entire trial. The efficacy and tolerability were evaluated by the patients and doctors as “good” to “very good” in more than 85%.
CONCLUSION: Euphrasia single-dose eye drops can effectively and safely be used for various conjunctival conditions by general practitioners and ophthalmologists. A dosage of one drop three times a day seems to be the general prescribed dosage.
Goldenseal (Hydrastis canadenisis) is a native American medicinal plant used as an immune stimulant. Astragalus (Astragalus membranaceus) is a widely used herbal product in China, other Asian countries, and the United States as an immune stimulant to be taken on first clinical signs of infection. In this study, the innate effects of goldenseal and Astragalus on pro-inflammatory cytokines produced by cultured macrophages were examined using two different commercial preparations of goldenseal and Astragalus. Both goldenseal and Astragalus were found to exhibit little to no direct effect on stimulation of mouse macrophages (J774A.1 cells), with only Astragalus able to affect production of tumor necrosis factor (TNF)-alpha when used in high concentrations. However, both goldenseal and Astragalus were able to modify responses from lipopolysaccharide-stimulated macrophages, with identified immunomodulatory effects to reduce production of TNF-alpha, interleukin (IL)-6, IL-10, and IL-12 in a dose-dependent manner. The results obtained indicate that both goldenseal and Astragalus exhibit abilities to modulate macrophage responses during stimulation. Therefore, it is hypothesized that their historical use as therapeutic agents may be due to reduction in the pro-inflammatory response that indirectly leads to limiting of clinical symptoms during infection. Both products differ in their immune stimulatory patterns, offering insight into differential use and therapeutic potential of these products to regulate macrophage immune responses and activation events.