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Dai Miyazaki, Atsuki Fukushima, Yuichi Ohashi, Nobuyuki Ebihara, Eiichi Uchio, Shigeki Okamoto, Jun Shoji, Etsuko Takamura, Yayoi Nakagawa, Kenichi Namba, Hiroshi Fujishima; Steroid sparing effect of 0.1% tacrolimus eye drops for treatment of shield ulcer and corneal epitheliopathy in refractory allergic ocular diseases. Invest. Ophthalmol. Vis. Sci. 2016;57(12):303.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate steroid sparing effect of 0.1% tacrolimus eye drops for treatment of shield ulcer and corneal epitheliopathy in refractory allergic ocular diseases.
Clinical findings from the multi-center study involving 761 eyes of 761 patients with shield ulcer or corneal epitheliopathy were retrospectively analyzed. Of them, 231 patients were shield ulcer. All the patients were treated with tacrolimus eye drops, and 399 patients (52%) necessitated with topical steroids in conjunction during the 3 months follow up. Clinical signs were rated on a 4 grade scale. For corneal epitheliopathy, no corneal staining was 0, and shield ulcer was 3 as highest.
The mean epitheliopathy score at baseline was 2.02± 0.80 (SD) for steroid-treated patients, and 1.80±0.82 for patients without steroids. After 1 month of tacrolimus treatment, epitheliopathy score significantly reduced to 0.86±0.97 and 0.63±0.88, respectively. For shield ulcer patients, epitheliopathy score significantly reduced to 1.45±1.13 and 1.39±1.18, respectively. No significant difference by steroid use was observed.To assess score reduction effect of topical tacrolimus and steroids for epitheliopathy, multi-level linear regression analysis was conducted. Tacrolimus eye drops significantly reduced score by 1.36 (P<0.0005) within 1 month after adjustment of age, giant papilla score and steroid use. In contrast, reduction effect of topical steroid was minimal and insignificant (0.09 for fluorometholone, and -0.06 for betamethasone).
Tacrolimus eye drops had significant steroid sparing effect for treatment of shield ulcer or epitheliopathy, and allow non-steroidal therapy for management of shield ulcer and corneal epitheliopathy.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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