Research Article
Volume 11 Issue 12 - 2020
Efficacy of Topical Cyclosporine in the Treatment of Atopic and Vernal Keratoconjunctivitis
Maria Akhtar Dalia1, Mohammad Kumruzzaman Sarker1, Md Zainal Abedin1, Mahfuz-Ul-Anwar1, Moni Rani2 and Ratindra Nath Mondal3*
1Rangpur Medical College, Rangpur, Bangladesh
2Rajshahi Medical College, Rajshahi, Bangladesh
3Society of General Physicians and Daktarkhana (GP Center), Rangpur, Bangladesh
*Corresponding Author: Ratindra Nath Mondal, Society of General Physicians and Daktarkhana (GP Center), Rangpur, Bangladesh.
Received: September 28, 2020; Published: November 07, 2020




Abstract

Background: Atopic and vernal keratoconjunctivitis can be treated with a variety of medications, including topical antihistamines, mast cell stabilizers, nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. But none proven to be effective and safe for long term use.

Methods: An intervention study was conducted on 70 atopic and 70 vernal keratoconjunctivitis patients in NIO&H Dhaka during the period of August 2010 to January 2011. All the subjects received topical cyclosporine 0.05%. 20 patients were lost to follow up and remaining 120 patients’ (60 patients were atopic and 60 patients were vernal keratoconjunctivitis) data was analyzed.

Result: Mean age of the vernal and atopic keratoconjunctivitis mean age were 7.32 ± 3.52 (SD) and 32.07 ± 9.80 respectively. In both the group male were more than female (VKC male vs female 73.3% vs 23.7%, AKC 53.3% vs 46.7%). At the baseline, 100% of the vernal and atopic keratoconjunctivitis patients had itching, discharge, redness and irritation. Photophobia was more in vernal keratoconjunctivitis 40% than atopic keratoconjunctivitis 6.7% (p < 0.001). Allergy was more common in atopic keratoconjunctivitis (93.3%) than vernal keratoconjunctivitis (46.7%) (p < 0.001). Co-existence of asthma was equal in atopic and veneral keratoconjunctivitis 40%), but eczema was more in atopic keratoconjunctivitis patients 93.3% than veneral atopic keratoconjunctivitis patients 18.3% (p < 0.001).

After 15 days of treatment, lacrimation status improved in 93.3% of atopic and 60% of veneral keratoconjunctivitis patients. There was no significant improvement of other symptoms after 15 days and 1 month. After completion of 3 months treatment 93.3% patients improved in case of atopic keratoconjunctivitis and 91% in vernal keratoconjunctivitis.

Conclusion: In our study topical cyclosporine 0.05% was found effective in both atopic and vernal keratoconjunctivitis.

Keywords: Cyclosporine; Atopic; Vernal; Keratoconjunctivitis

References

  1. Foster CS and Calonge MD. “Atopic keratoconjunctivitis”. Ophthalmology 98 (1990): 992-1000.
  2. Power WJ., et al. “Long-term follow-up of patients with atopic keratoconjunctivitis”. Ophthalmology 105 (1998): 637-642.
  3. , et al. “A randomized trial of topical cyclosporine 0.05% in topical steroid resistant atopic keratoconjunctivitis”. Ophthalmology 111 (2004): 476-482.
  4. Dart JKG., et al. “Perennial allergic conjunctivitis; definition, clinical characteristics and prevalence”. Transactions of the ophthalmological societies of the United Kingdom 105 (1986): 513-520.
  5. Tuft SJ., et al. “Clinical features of atopic keratoconjunctivitis”. Ophthalmology 98 (1991): 150-158.
  6. D Bremond-Gignac., et al. “Prevalence of vernal keratoconjunctivitis: a rare disease?” British Journal of Ophthalmology 92 (2008): 1097-1102.
  7. S Talitlipinar and E K Akpek. “Topical ciclosporin in the treatment of ocular surface disorders”. British Journal of Ophthalmology 10 (2005): 1363-1367.
  8. Zaman K., et al. “Asthma in rural Bangladeshi children”. Indian Journal of Pediatrics 74 (2007): 539Y543.
  9. Ruby Pawankar., et al. “State of world allergy report 2008: allergy and chronic respiratory diseases”. World Allergy Organization Journal 6 (2008): S4-S17.
  10. Hingorani M and Lightman S. “Therapeutic option in ocular allergic disease”. Drugs 50 (1995): 208-221.
  11. , et al. “Treating the ocular component of allergic rhino conjunctivitis and related disorders”. Medscape General Medicine 9.3 (2007): 35.
  12. Skalka H and Prechal J. “Effect of corticosteroids on cataract formation”. Archives of Ophthalmology 98 (1980): 1773-1777.
  13. Kolker A., et al. “Dexamethasone testing in prison inmates”. Investigative Ophthalmology 10 (1971): 198-202.
  14. Swamy B., et al. “Topical non-steroidal anti inflammatory drugs in allergic conjunctivitis: Meta analysis of randomised trial data”. Ophthalmic Epidemiology 14 (2007): 311-319.
  15. Nussenblat RB and Palestine AG. “Cyclosporin A: immunology, pharmacology and therapeutic uses”. Survey of Ophthalmology 31 (1986): 159-169.
  16. Monnick McGill., et al. “Allergic eye disease mechanisms”. British Journal of Ophthalmology 82 (1998): 1203-1214.
  17. Hunter PA., et al. “Cyclosporin A applied topically to the recipient eye inhibits corneal graft rejection”. Clinical and Experimental Immunology 45 (1981): 173-177.
  18. Kana JS., et al. “Rabbit corneal allograft survival following topical administration of cyclosporin A”. Investigative Ophthalmology and Visual Science 22 (1982): 686-690.
  19. Behrens-Beuman W., et al. “The effect of topical Cyclosporin A on the rabbit cornea: a clinical and electron microscopic study”. Graefe's Archive for Clinical and Experimental Ophthalmology 224 (1986): 520-524.
  20. Zierhut M., et al. “Topical treatment of severe corneal ulcers with cyclosporin A”. Graefe's Archive for Clinical and Experimental Ophthalmology 227 (1989): 30-35.
  21. Holland EJ., et al. “Topical cyclosporine A in the treatment of anterior segment inflammatory disease”. Cornea 12 (1993): 413-419.
  22. Gunduz K and Ozdemir O. “Therapeutic use of topical cyclosporine.as an adjunct to topical acyclovir treatment in herpetic stromal keratitis”. Ophthalmic Research 29 (1997): 405-408.
  23. Gottsch JD and Akpek EK. “Topical cyclosporine stimulates neovascularization in resolving sterile rheumatoid central corneal ulcers”. Transactions of the American Ophthalmological Society 98 (2000): 81-87.
  24. Del Castillo JM., et al. “Effect of topical cyclosporine A on Thygesons superficial Punctate keratitis”. Documenta Ophthalmologica 93 (1996): 193-198.
  25. Bleik JH and Tabara KF. “Topical Cyclosporin in vernal keratoconjunctivitis”. Ophthalmology 98 (1991): 1679-1684.
  26. Bonini S., et al. “Vernal Keratoconjunctivitis revisited. A case series of 195 patients with long term follow up”. Ophthalmology 107 (2000): 1157-1163.
  27. Anne Chang-Godinich. Atopic Keratoconjunctivitis (AKC).
  28. Holden B., et al. “Myopia, an underrated global challenge to vision: where the current data takes us on myopia control”. Eye 28 (2014): 142-146.
  29. Khan AO., et al. “The distinct ophthalmic phenotype of Knobloch syndrome in children”. British Journal of Ophthalmology 96 (2012): 890-895.
  30. Avunduk AM., et al. “Cyclosporin effects on clinical findings and impression cytology specimens in severe vernal keratoconjunctivitis”. Ophthalmologica 215 (2001): 290-293.
  31. Akpek Ek., et al. “A randomised trial of topical cyclosporine 0.05% in topical steroid-resistant atopic keratoconjunctivitis”. Ophthalmology 111 (2004): 476-482.
  32. BenEzra D., et al. “Cyclosporin eyedrops for the treatment of severe vernal keratoconjunctivitis”. American Journal of Ophthalmology 101 (1986): 278-282.
  33. Secchi AG., et al. “Topical use of cyclosporin in the treatment of vernal keratoconjunctivitis”. American Journal of Ophthalmology 110 (1990): 641-645.
  34. Cetinkaya A., et al. “Topical cyclosporin in the management of shield ulcers”. Cornea 23 (2004): 194-200.
  35. Ozcan A A., et al. “Management of severe allergic conjunctivitis with topical cyclosporine A 0.05% eyedrops”. Cornea (2007).
Citation: Ratindra Nath Mondal., et al. “Efficacy of Topical Cyclosporine in the Treatment of Atopic and Vernal Keratoconjunctivitis”. EC Ophthalmology 11.12 (2020): 01-08.

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