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S. A. Issa, K. Aye, S. Manvikar, F. Figueiredo; Clinical Presentation, Management and Outcomes of Thygeson’s Superficial Punctate Keratitis in the UK. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2377. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To describe presentation, management and outcomes of Thygeson’s Superficial Punctate Keratitis (TSPK) in UK.
A retrospective review of consecutive cases of TSPK which presented to the Ocular Surface Service from Sep1998 to Nov 2007.
Twenty cases were studied (14 females: 6 males). Age at presentation had a mean of 39.9 years (range; 5 - 72). Both eyes were affected in 18 (90%) cases. In two female cases only one eye was affected. Average follow up was 41 months (range; 2 - 115). Right and left best corrected visual acuities improved after topical treatment from a LogMAR equivalent of 0.18 to 0.06 and 0.13 to 0.05 respectively. We divided the cases into three groups according to treatment. Group 1: Female patients (n=2) ages 37 and 52 were managed by topical lubricants only. TSPK resolved and both patients had no recurrence. Group 2: Patients were managed with topical steroid (mean age; 45 years). There were two males and four females. The youngest patient was 5 years old. He needed a bandage contact lens which was more effective as it was difficult to instil drops in his eyes. Four patients had a short course of TSPK (2 - 24 months) and did not have recurrences after stopping topical steroids. One patient had a long course (43 months) and had three recurrences after stopping the steroid drops but eventually did not need treatment. Group 3: Patients (n=12) were initially started on topical steroid but had significant recurrences after stopping it. These patients were given topical cyclosporine-A (CsA) 2% eye drop on alternate days and a reducing dose of topical steroids (eventually stopped). The mean age was 36.5 years (4 males and 8 females). The period between starting steroid and CsA treatment ranged from 3 months to 7 years (mean; 18 months). Six of the 12 patients were able to stop CsA without recurrences (duration of treatment: 12 - 56 months). The remaining 6 patients needed long term low dose CsA to prevent recurrences and stayed on it once or twice a week. Some patients complained of stinging after instilling CsA, however there were no other significant side effects.
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