Clinical effectiveness and local side effects of topical 0.05% cyclosporine in treatment of children with severe vernal keratoconjunctivitis

Doi: 10.36351/pjo.v38i2.1288

Abstract

Purpose: To evaluate the therapeutic response of topical cyclosporine (CyS-A) in patients with vernal keratoconjunctivitis (VKC), resistant to topical mast cell stabilizer (MCS) and anti-histamine therapy.

Study Design: Quasi experimental study.

Place and Duration of Study: Qazi Hussain Ahmad Medical Complex, Nowshera, from April 2019 to August 2019.

Methods: Forty patients, 30 males and 10 females, less than 18 years of age and diagnosed with Vernal Keratoconjunctivitis were enrolled in the study. All participants were graded based upon severity of the disease at presentation with a score of 0 for normal, 1 for mild, 2 for moderate and 3 for severe, for both symptoms and signs. Each patient received topical CyS-A 0.05%in QID regimen in addition to lubricating tear substitute. Followup was done for 04 months.

Results: Clinical scoring was done at baseline and at the 1st, 2nd and 4th month following therapy. After 4 months of topical application, not only the patients improved symptomatically but their clinical signs also improved, which achieved a level of statistical significance (p < 0.05). All participants completed the follow-up duration of therapy. Although Horner Tranta’s dot showed improvement, but comparison of baseline with 1st month values were statistically non-significant (p = 0.048). However, during 2nd and 4th month, the improvement achieved statistical significance (p = 0.013 and p = 0.006 respectively). None of the participants reported any bothersome local side effect.

Conclusion: Topical cyclosporine 0.05% is effective in alleviating the symptoms and signs without any local side effects in resistant VKC.

Key Words: Vernal keratoconjunctivitis, Cyclosporine, Cobblestone Papillae.