{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:44:24Z","timestamp":1787013864811,"version":"build-2736575974"},"reference-count":53,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,3,28]],"date-time":"2021-03-28T00:00:00Z","timestamp":1616889600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To systematically review the literature on the treatment of vernal keratoconjunctivitis (VKC) in children and young adults and conduct comparative efficacy analysis on clinical signs and symptoms using network meta\u2010analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched the databases PubMed\/MEDLINE, EMBASE, Cochrane Central and Web of Science on 21 October 2019 for randomized controlled trials (RCT). Studies considered had patients with VKC\u2009&lt;\u200920\u2009years of age randomized into either intervention (any medical intervention) or comparator (active treatment, placebo treatment or non\u2010treatment control), where pre\u2010defined outcomes (data from \u22652\u2009weeks and as close as possible to 2\u2009months) of symptoms (itching, tearing, photophobia and foreign body sensation) and signs (hyperaemia, punctate keratitis, Horner\u2010Trantas dots and macropapillae) were reported. Risk of bias within studies was evaluated using the Cochrane risk of bias tool. Comparisons were made using network meta\u2010analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 39 studies with data on 2046 individuals. Twenty\u2010three studies were eligible for quantitative analyses. None were systemic therapy. Temporal trend analysis showed that an initial focus on topical mast cell stabilizers turned to a focus on calcineurin inhibitors and a more diverse variety of pharmacological strategies. Studies varied in population, treatment duration and quality. The quantitative analysis revealed that efficacy of different therapies differed substantially across important clinical signs and symptoms, but there was a general trend of superior efficacy when using topical corticosteroids with stronger efficacy of the more potent corticosteroids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We provide an overview of RCTs comparing the efficacy of treatments for VKC in children and young adults, which we find differs across symptoms and signs. Overall, we saw a general trend of superior efficacy with topical corticosteroids. However, our findings highlight the need for better studies, consensus on core outcomes and potential for individualized therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aos.14858","type":"journal-article","created":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T01:35:03Z","timestamp":1616981703000},"page":"35-44","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Comparative efficacy of medical treatments for vernal keratoconjunctivitis in children and young adults: a systematic review with network meta\u2010analyses"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9392-8697","authenticated-orcid":false,"given":"Marie Louise Roed","family":"Rasmussen","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne Guldager","family":"Schou","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8249-5104","authenticated-orcid":false,"given":"Daniella","family":"Bach\u2010Holm","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Heegaard","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christel Asserina Bjerregaard","family":"J\u00f8rgensen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9375-1510","authenticated-orcid":false,"given":"Line","family":"Kessel","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Katrine","family":"Wiencke","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6620-5365","authenticated-orcid":false,"given":"Yousif","family":"Subhi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,28]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.14260\/Jemds\/2017\/245"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(00)00089-0"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(91)32069-4"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.1992.139"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.eye.6700675"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2007.117812"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(14)74786-5"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.1996.93"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2011-300415"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/XEB.0000000000000140"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.1972.tb01274.x"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/02713688209020009"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.78.5.365"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(88)33201-X"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(14)74850-0"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01203856"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(00)00538-8"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000267878"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2001.10"},{"key":"e_1_2_5_21_1","unstructured":"HigginsJPT ThomasJ ChandlerJ CumpstonM LiT&PageMJ. 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