Efficacy, Safety and Steroid-sparing Effect of Topical Cyclosporine A 0.05% for Vernal Keratoconjunctivitis in Indian Children

• Published in: Journal of ophthalmic & vision research Vol. 14; no. 4; pp. 412 - 418
• Main Authors: Chatterjee, Arkendu, Bandyopadhyay, Sabyasachi, Kumar Bandyopadhyay, Samir
• Format: Journal Article
• Language: English
• Published: United Arab Emirates PUBLISHED BY KNOWLEDGE E 01.10.2019; Knowledge E
• Subjects: Allergic Conjunctivitis; Intraocular Pressure; Original; Topical Cyclosporine A; Topical Loteprednol Etabonate; Vernal Keratoconjunctivitis; Topical Loteprednol Etabonate; Vernal Keratoconjunctivitis; Topical Cyclosporine A; Intraocular Pressure; Allergic Conjunctivitis
• ISSN: 2008-2010; 2008-322X
• DOI: 10.18502/jovr.v14i4.5439

To evaluate the efficacy, safety, and steroid-sparing effect of topical cyclosporine A (Cs A) 0.05% in patients with moderate to severe steroid dependent vernal keratoconjunctivitis (VKC). A prospective, comparative, placebo controlled study was carried out on 68 VKC patients, with 34 patients treated with topical Cs A 0.05% and the remaining 34 with topical carboxymethyl cellulose 0.5% (placebo). Both groups also received topical loteprednol etabonate 0.5%. Symptom (itching, photophobia, tearing, and discharge) score, sign (tarsal and limbal papillae, corneal involvement, and conjunctival hyperemia) score, and drug score (steroid drop usage/day/eye) were recorded at baseline and each follow-up visit. The intraocular pressure (IOP) measurement and evaluation of any ocular side effects were carried out. Significant reduction in symptom score and sign score was seen in both groups. Cs A group significantly showed more reduction in symptom ( 0.0001 in all follow-up visits) and sign ( 0.0001 in all follow-up visits) scores compared to the placebo group. At day 7, mean steroid usage reduced from 4 to 3.44 0.5 and 3.79 0.4 in Cs A and placebo groups, respectively ( 0.0001). Steroid drops completely stopped in 21 patients at day 60 in the Cs A group compared to none in the placebo group. No significant rise in IOP or any side effects were noted in either group. Topical Cs A 0.05% is effective and safe in patients with moderate to severe VKC with good steroid-sparing effect.