Document Detail

Systemic cyclosporin A in severe atopic keratoconjunctivitis.
MedLine Citation:
PMID:  20491051     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Severe atopic keratoconjunctivitis (AKC) is associated with atopic dermatitis and is often refractory to topical treatment and potentially blinding. Because T lymphocytes are central in the pathogenesis of these diseases, systemic cyclosporin A (CSA) should treat both dermatologic and ocular manifestations. We describe the successful treatment of 8 patients with severe AKC, resistant to conventional management, with systemic CSA. METHODS: This was a retrospective observational case series. The notes of patients with severe AKC were reviewed, where the disease did not respond to topical or other systemic treatment, and was treated with systemic CSA. Response to such treatment was observed and reported in 8 patients. RESULTS: Cyclosporin A was effective as a steroid-sparing agent. Systemic corticosteroids were stopped in half of the patients. Dosage varied between 50 mg and 300 mg daily (in divided doses), and duration of treatment varied between 5 months and 7 years. Papillary blepharoconjunctivitis and punctuate keratopathy completely resolved a few weeks after CSA therapy. Corneal ulcers resolved after 5 to 10 weeks of treatment. Coexistent eczema or dermatitis was brought under control with systemic immunosuppression, and flare-ups were not present during the duration of treatment. There was remission of AKC in all 8 patients with increase in visual acuity and low incidence of side effects. CONCLUSIONS: Cyclosporin A is effective in the treatment of atopic dermatitis and keratoconjunctivitis. Our case series potentiates previous smaller case series that systemic CSA can be used effectively and safely in cases that are resistant to conventional treatment to preserve vision.
Kurt Spiteri Cornish; Maria Elena Gregory; Katheravelu Ramaesh
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  European journal of ophthalmology     Volume:  20     ISSN:  1724-6016     ISO Abbreviation:  Eur J Ophthalmol     Publication Date:    2010 Sep-Oct
Date Detail:
Created Date:  2010-08-02     Completed Date:  2010-10-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9110772     Medline TA:  Eur J Ophthalmol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  844-51     Citation Subset:  IM    
Tennent Institute of Ophthalmology, Glasgow, UK.
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MeSH Terms
Blepharitis / drug therapy
Conjunctivitis, Allergic / drug therapy*,  immunology
Cyclosporine / therapeutic use*
Dermatitis, Atopic / drug therapy
Immunosuppressive Agents / therapeutic use*
Middle Aged
Retrospective Studies
T-Lymphocytes / immunology
Treatment Outcome
Visual Acuity
Young Adult
Reg. No./Substance:
0/Immunosuppressive Agents; 59865-13-3/Cyclosporine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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