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Efficacy and safety of low-dose topical tacrolimus in vernal keratoconjunctivitis

Authors Shoughy SS, Jaroudi MO, Tabbara KF

Received 26 October 2015

Accepted for publication 31 December 2015

Published 7 April 2016 Volume 2016:10 Pages 643—647

DOI https://doi.org/10.2147/OPTH.S99157

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Gokcen Gökçe

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Samir S Shoughy,1 Mahmoud O Jaroudi,1 Khalid F Tabbara1–3

1The Eye Center and The Eye Foundation for Research in Ophthalmology, 2Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 3Wilmer Ophthalmological Institute of the Johns Hopkins University School of Medicine, Baltimore, MD, USA

Objective: The objective of this study was to evaluate the efficacy and safety of topical low-dose tacrolimus (0.01%) solution in patients with vernal keratoconjunctivitis (VKC).
Patients and methods: A total of 62 consecutive patients with VKC refractory to conventional treatment were included retrospectively. Tacrolimus 0.01% ophthalmic solution was administered to patients twice daily after discontinuation of all previous topical medications. The duration of treatment ranged from 1 month to 29 months. The clinical symptoms of itching, redness, foreign body sensation, and discharge and the clinical signs of conjunctival hyperemia, conjunctival papillary hypertrophy, limbal infiltration, Trantas dots, and superficial punctate keratopathy were graded as 0 (normal), 1+ (mild), 2+ (moderate), or 3+ (severe). Assessment was carried out before initiation of therapy and on the last visit after treatment.
Results:
There were 62 patients with VKC comprising 49 male and 13 female patients. The median age was 12 years (range: 5–47 years). The mean visual acuity improved from 20/30 to 20/25 following treatment. There was statistically significant improvement in symptoms of itching (P<0.001), redness (P<0.001), foreign body sensation (P<0.001), and discharge (P<0.001). Statistically significant improvement was also observed in clinical signs of conjunctival hyperemia (P<0.001), limbal infiltration (P<0.001), Trantas dots (P<0.001), superficial punctate keratopathy (P<0.001), and conjunctival papillary hypertrophy (P<0.001). The solution form of tacrolimus was well tolerated. None of the patients developed elevation of intraocular pressure, cataract, or infectious keratitis.
Conclusion: Low-dose topical tacrolimus 0.01% solution is effective and safe in the management of patients with refractory VKC.

Keywords: topical, solution, tacrolimus, vernal keratoconjunctivitis

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