Abstract
Purpose :
Although vernal keratoconjunctivitis (VKC) is known to be self-limiting and become milder with age, it can sometimes occur in elderly subjects. In this retrospective study, we investigated the effect of 0.1% tacrolimus (TL) eye drops in young and elder VKC patients.
Methods :
In this study, 8 eyes of 8 young VKC patients [7 males, 1 female; mean age: 9.1±1.0 (SD) years] treated with TL (twice daily) in addition to the baseline treatment with or without topical steroid were compared with 8 eyes from 8 age-matched male VKC patients (mean age: 8.5±0.8 years) treated with baseline treatment only. In those patients, improvement of subjective symptoms (SSs) including itching, discharge, lacrimation, sensitivity to light, foreign body sensation, and eye pain, and objective findings (OFs) including redness and swelling of bulbar or palpebral conjunctiva, follicle, papilla, giant papilla, Trantas dots and/or thickening of limbus, and corneal epithelial damage, each graded from 0 to 3 (0=none, 1, 2, and 3=mild, moderate, and severe), were assessed before and at 1, 3, 6, 9, 12, 18 months post treatment. In 5 elder male VKC patients (mean age: 42.6±5.0 years), the treatment effect was compared between 18 months before and after starting TL in addition to the baseline treatment.
Results :
In young VKC patients treated with TL, significant improvement was seen in both SSs and OFs (SSs: OFs) until 6-months post treatment (0.8±1.5; 7.9±2.7) (p<0.05), followed by mild improvement with decreased use of topical steroid until at 18 months compared to before the TL treatment (7.0±7.2; 11.2±2.8). However, 8 younger VKC patients treated without TL showed variable improvement in SSs and OFs, with no significant improvement at 6 months (9.0±4.6; 14.0±4.7) post treatment compared to that before treatment (10.6±6.0; 16.8±2.1). In elder VKC patients, significant improvement was seen in SSs and OFs at 6-months post TL treatment (0.8±0.8; 6.6±3.3) compared with that before treatment (12.0±6.6; 12.2±3.1), followed by stable improvement until at 18 months. However, those patients showed no significant improvement for 18 months before starting TL treatment.
Conclusions :
We found 0.1 % tacrolimus eye drops to be effective in both young and elder patients with VKC.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.