Abstract
Purpose :
To examine the efficacy of 0.1% tacrolimus ophthalmic suspension in treating scleritis.
Methods :
This was a single center prospective clinical study. Nine patients with scleritis who were refractory to conventional steroid treatments were included and were treated with 0.1% tacrolimus ophthalmic suspension q.i.d or b.i.d. The mean age of the patients was 59.6 ± 10.5 years (range, 44 - 73 years). A subjective and two objective signs were observed at baseline (before treatment), 1 and 2 weeks, 1, 2, 3 and 6 months after treatment initiation. Bulbar conjunctival hyperemia and pain scale were assessed using 5 grades (0 = None; 1+ = Mild; 2+ =Moderate; 3+ = Severe; 4+ = extremely severe). Intraocular pressure (IOP) was measured with non-contact tonometry (NCT). Safety was assessed based on the severity and the incidence of adverse events.
Results :
The scores of bulbar conjunctival hyperemia and pain scale significantly decreased from baseline 1 week after initiating tacrolimus eye drop treatment (Both P < 0.001). The mean score of bulbar conjunctival hyperemia was 3.8 ± 0.4 at the beginning of treatment and decreased to 0.2 ± 0.4 at 6 months after initiation. The mean score of pain scale was 3.6 ± 0.7 at the beginning of treatment and was completely reduced to 0 in all patients at 6 months after initiation. Although IOP gradually decreased, there was no significant difference from baseline (P = 0.05). Treatment was gradually tapered with increasing intervals between applications. Additional medications, such as steroids, were not required to provide relief in all patients during follow-up. All patients complained of a mild burning sensation upon application, which was well-tolerated. No patient discontinued treatment and had infectious adverse events after initiation.
Conclusions :
The results of this study suggested that 0.1% tacrolimus ophthalmic suspension was effective in the treatment of scleritis cases refractory to standard conventional steroid treatment.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.