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Jason Kim, Anton Kolomeyer, Christina Fang, Natasha Nayak, Eliott Kim, David Chu; Topical Cyclosporine A for the Treatment of Chronic Keratoconjunctivitis. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2125.
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To describe the use of Cyclosporine A (CsA) in patients with chronic keratoconjunctivitis (KC).
This study was a retrospective chart review at a tertiary care center. Patients treated with topical CsA (1% emulsion) for various types of KC between August 2001 and November 2012 were included. Main outcome measures included degree of inflammation, ability to taper steroids, visual acuity (VA), and reported side effects.
Thirty-one eyes of 17 patients (11 [65%] males and 6 [56%] females; mean age of all the patients was 47.9 ± 17.1 years) met the study criteria. Fourteen (82%) patients had chronic epidemic KC, some of which were dependent on topical steroids, two (12%) patients had Thygeson’s disease, and one (5.9%) patient had vernal KC. Eleven (65%) patients were receiving concomitant topical steroids initially and all were able to taper the dose with use of CsA after 3.5 ± 2.5 months. Nine (53%) patients reported ocular discomfort and burning. One (5.9%) patient discontinued CsA because of irritation and one (5.9%) reduced CsA dosage to 0.5% after four weeks of treatment due to burning sensation. One (5.9%) patient increased the dosage from 1% to 2% after 38 weeks to achieve better control. Inflammation was controlled in 16 (94%) patients.
Management of KC with topical CsA resulted in inflammation control and allowed for steroid taper in the majority of patients without severe complications. This shows that, in most cases, CsA can be used to manage the effects of chronic KC.
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