Corticosteroid as Treatment in Infective Conjunctivitis: A Systematic Literature Review and Meta-Analysis

Corticosteroid use as an anti-inflammatory agent in infective conjunctivitis has been met with concerns about prolonged infection. This systematic review aims to evaluate the safety and efficacy of corticosteroids as a treatment for infective conjunctivitis. A comprehensive search was conducted on PubMed, Cochrane, Scopus, ScienceDirect, Embase, and ProQuest for clinical trials of topical corticosteroids with or without combination with other medications in bacterial or viral conjunctivitis up to November 2023. The studies were screened, and data on safety and efficacy were extracted. The quality of studies was assessed using the Jadad Scale. Meta-analysis was performed using the random-effects model, with heterogeneity assessed with the I² statistic. We found ten clinical trials that met the inclusion criteria. Overall meta-analysis revealed significant clinical resolution in dexamethasone-containing therapy compared to non-corticosteroid treatment (OR 1.51; 95% CI 1.19-1.92), with several studies reporting significantly reduced clinical symptoms severity. Two of the six studies assessing viral and bacterial eradication reported significantly improved viral clearance rates. Meta-analysis indicated no difference in ocular adverse effects compared to nonsteroid therapy (OR 1.33; 95% CI 0.82-2.16). In conclusion, corticosteroid use in infective conjunctivitis is relatively safe and may help improve clinical resolution and reduce symptom severity, especially when combined with antibiotics and antiseptics.