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Researchers say tacrolimus may be first-line treatment for patients with VKC
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Low-dose topical tacrolimus 0.01% solution showed long-term, positive results as a steroid-sparing agent in the management of refractory vernal keratoconjunctivitis, according to researchers in Clinical Ophthalmology.
A total of 62 consecutive patients with bilateral VKC, unaffected by conventional topical treatments were included in the retrospective review.
Tacrolimus 0.01% ophthalmic solution was administered twice daily, and previous topical medications were discontinued.
Treatment duration ranged from 1 month to 29 months, and clinical assessment was held before, during and on the last visit after treatment, averaging 9 months. On the last follow-up visit, patients were evaluated for improvement in subjective symptoms including itching, redness, foreign body sensation and discharge.
Clinical signs such as: conjunctival hyperemia, conjunctival papillary hypertrophy, limbal infiltration, Trantas dots and superficial punctate keratopathy were graded as 0 (normal), 1+ (mild), 2+ (moderate) or 3+ (severe), according to the study.
At presentation, mean visual acuity was 20/30, and mean intraocular pressure was 14 mm Hg. On the last visit, mean visual acuity was 20/25 and mean IOP was 13 mm Hg, according to researchers.
At presentation, the main symptoms were itching in 81% patients, redness in 79%, discharge in 50% and foreign body sensation in 27%. Clinical signs included conjunctival hyperemia in 79% of patients, conjunctival hypertrophy in 55%, Trantas dots in 56%, limbal hypertrophy in 66% and superficial punctate keratitis in 27%.
The clinical signs of conjunctival hyperemia, limbal infiltration, Trantas dots, superficial punctate keratopathy and conjunctival papillary hypertrophy all statistically improved, according to researchers. They also found significant improvement in itching, redness, foreign body sensation and discharge.
No patient developed an increase in IOP, cataract or infectious keratitis. – by Abigail Sutton
Disclosure: The researchers reported no relevant financial disclosures.
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