July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Topical tacrolimus limits ocular hypertensive responses in topical steroid-treated eyes with refractory allergic ocular diseases
Author Affiliations & Notes
  • Dai Miyazaki
    Ophthalmology, Tottori University, Yonago, Japan
  • Fumie Ehara
    Ophthalmology, Tottori University, Yonago, Japan
  • Yoshitsugu Inoue
    Ophthalmology, Tottori University, Yonago, Japan
  • Atsuki Fukushima
    Kochi Univ, Japan
  • Yuichi Ohashi
    Ehime Univ, Japan
  • Nobuyuki Ebihara
    Juntendo Univ, Japan
  • Eiichi Uchio
    Fukuoka Univ, Japan
  • Shigeki Okamoto
    Okamoto Eye Clinic, Japan
  • Jun Shoji
    Nihon Univ, Japan
  • Etsuko Takamura
    Tokyo Women's Medical University, Japan
  • Kenichi Namba
    Hokkaido Univ, Japan
  • Hiroshi Fujishima
    Tsurumi Univ School of Dental Med, Japan
  • Footnotes
    Commercial Relationships   Dai Miyazaki, Santen (R), Senju (F); Fumie Ehara, None; Yoshitsugu Inoue, Senju (C); Atsuki Fukushima, None; Yuichi Ohashi, None; Nobuyuki Ebihara, None; Eiichi Uchio, None; Shigeki Okamoto, None; Jun Shoji, None; Etsuko Takamura, None; Kenichi Namba, None; Hiroshi Fujishima, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 2401. doi:
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      Dai Miyazaki, Fumie Ehara, Yoshitsugu Inoue, Atsuki Fukushima, Yuichi Ohashi, Nobuyuki Ebihara, Eiichi Uchio, Shigeki Okamoto, Jun Shoji, Etsuko Takamura, Kenichi Namba, Hiroshi Fujishima; Topical tacrolimus limits ocular hypertensive responses in topical steroid-treated eyes with refractory allergic ocular diseases. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2401.

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

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Purpose : Myocilin is typically induced by trabecular meshwork by steroid treatment, and considered associated with IOP elevation after steroid treatment in young patients. Myocilin induction in trabecular meshwork is dependent on NFAT activity, and can be inhibited by calcineurin inhibitor. Purpose of this study is to assess whether potent calcineurin inhibitor, tacrolimus, may limits steroid-induced IOP elevation in young subjects.

Methods : One thousand two hundreds and thirteen refractory allergic conjunctivitis patients in young age, who were treated with topical tacrolimus, were analyzed for steroid-induced IOP change (per month, compared to baseline) during the 3 months follow-up using mixed linear regression analysis and treatment effect model. Effects of tacrolimus use and clinical characteristics which affect steroid-induced IOP elevation were examined using meta-regression analysis of previous literatures.

Results : Meta-regression analysis indicated that topical steroid (betamethasone class)-induced IOP elevation was 4.9 mmHg (95%CI: 4.7-5.1).
In topical tacrolimus-treated eyes, betamethasone-induced IOP elevation was 1.3 mmHg (P=0.000, mixed linear regression), and were significantly lower than steroid-induced IOP elevation in eyes without tacrolimus. Analysis of treatment effect model confirmed limited steroid-induced IOP elevation in tacrolimus-treated eyes (1.1 mmHg, P=0.000).
Meta regression analysis indicated that tacrolimus was the significant factor for less IOP response in young patients. (P=0.000).

Conclusions : Topical tacrolimus use may limit steroid-induced ocular hypertension.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.


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