June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Topical Cyclosporine A for the Management of Chronic Follicular Conjunctivitis
Author Affiliations & Notes
  • Natasha Nayak
    Institute of Ophthalmology and Visual Science, University of Medicine and Dentistry of NJ, Newark, NJ
  • Anton Kolomeyer
    Institute of Ophthalmology and Visual Science, University of Medicine and Dentistry of NJ, Newark, NJ
  • Jason Kim
    Metropolitan Eye Research & Surgery Institute, Palisades Park, NJ
  • Eliott Kim
    Metropolitan Eye Research & Surgery Institute, Palisades Park, NJ
  • Christina Fang
    Institute of Ophthalmology and Visual Science, University of Medicine and Dentistry of NJ, Newark, NJ
  • David Chu
    Institute of Ophthalmology and Visual Science, University of Medicine and Dentistry of NJ, Newark, NJ
    Metropolitan Eye Research & Surgery Institute, Palisades Park, NJ
  • Footnotes
    Commercial Relationships Natasha Nayak, None; Anton Kolomeyer, None; Jason Kim, None; Eliott Kim, None; Christina Fang, None; David Chu, Abbott (F), Novartis (F), Santen (F), Eyegate (F), Lux Biosciences (F), Bausch & Lomb (R)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 2079. doi:
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    • Get Citation

      Natasha Nayak, Anton Kolomeyer, Jason Kim, Eliott Kim, Christina Fang, David Chu; Topical Cyclosporine A for the Management of Chronic Follicular Conjunctivitis. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2079.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To describe the use of Cyclosporine A (CsA) in patients with chronic follicular conjunctivitis (CFC).

Methods: This study was a retrospective chart review at a tertiary care center. Patients treated with topical CsA (1% emulsion) for idiopathic CFC between August 2001 and November 2012 were included. Biopsies were performed. Main outcome measures included time to reduced inflammation, final grade of inflammation (0-4; grading performed by one physician [DSC]), ability to taper steroids, final visual acuity (VA), and reported side effects. Unless otherwise noted, mean ± standard deviation (SD) were reported.

Results: Twenty-two eyes of 13 patients (nine [69%] females; 12 [92%] Caucasians; age of 49.5 ± 14.7 years) met study criteria. Two (15%) patients had an associated autoimmune disease (Sarcoidosis and Hashimoto’s thryroiditis/Sjogren’s syndrome). Mean follow-up time was 233 days (range, 33-887 days). CsA was initiated 50.6 days ± 46.9 days after diagnosis. Six (46%) patients ended CsA use after 182.2 ± 95.0 days, in all cases after inflammation was controlled. The remaining seven (54%) patients have ongoing management with CsA (currently for 278.9 ± 206.1 days). Final grade of inflammation (0.2 ± 0.4) was improved compared to initial grade of inflammation (2.1 ± 1.0) [two-tailed t-test, p-value < 0.0001]. Inflammation was controlled on average 40.1 ± 23.1 days (range, 5-84 days) after initiation of CsA. Eleven (85%) patients tapered and eventually discontinued topical steroids 31.5 ± 27.9 days after initiation of CsA treatment. One patient required re-initiation of topical steroids three months after initial discontinuation secondary to a flare up. Mean initial log MAR VA for right and left eyes was 0.090 and 0.067, respectively, whereas mean final VA was 0.089 and 0.028. Three (23%) patients reported mild ocular irritation and/or burning; however, none discontinued the eye drops.

Conclusions: Management of CFC with topical CsA resulted in inflammation control and allowed for steroid taper in the majority of patients without severe complications. Most patients require long-term CsA treatment.

Keywords: 475 conjunctivitis • 489 cyclosporine • 474 conjunctiva  
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