Purpose: A retrospective study for evaluating the clinical course of patients with vernal keratoconjunctivitis (VKC) treated with topical tacrolimus ophthalmic suspension 0.1% (Tacrolimus).
Subjects and methods: Subjects were 30 patients (24 men and 6 women) with VKC who were treated with a combined therapy of Tacrolimus and anti-allergic ophthalmic solution, and could be followed up for six months. The subjects were divided into two groups: 1. A conversion treatment group in which Tacrolimus was substituted for a steroid ophthalmic solution [21 patients; average age 14.7±9.44 years (mean±SD)] and 2. An additional treatment group receiving Tacrolimus and anti-allergic ophthalmic solution [9 patients; average age 28.2±7.31 years (mean±SD)]. The therapeutic effects of the patients were evaluated chronologically using the ocular clinical score according to the papillae-limbus-cornea grading score and eosinophil cationic protein (ECP) levels in tears.
Results: Papillae-limbus-cornea grading scores were significantly decreased from 8 (median) points at instillation initiation to 5 points at the first month after initiation of Tacrolimus treatment (p<0.01, Steel test). Tear ECP levels were significantly decreased from 3493.6 (median) ng/ml at instillation initiation to 205.6 ng/ml at the first month after initiation of Tacrolimus treatment (p<0.05, Steel test). During the course, four cases of exacerbation were found among the 30 cases, but no infections of the anterior segment were found.
Conclusion: The therapeutic effect of Tacrolimus eye drops for vernal keratoconjunctivitis was remarkable at one month after instillation initiation. For evaluating the effect of treatment and diagnosing exacerbation in VKC treated with Tacrolimus, a follow-up examination using clinical indexes such as the papillae-limbus-cornea grading score and ECP levels in tears is beneficial.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 118: 378-384, 2014.