Topical Cyclosporine A 1% for the Treatment of Chronic Follicular Conjunctivitis

• Published in: Eye & contact lens Vol. 41; no. 4; p. 210
• Main Authors: Kolomeyer, Anton M, Nayak, Natasha V, Ragam, Ashwinee, Kim, Jason S, Fang, Christina, Kim, Elliott S, Chu, David S
• Format: Journal Article
• Language: English
• Published: United States 01.07.2015
• Subjects: Administration, Topical; Adult; Aged; Cyclosporine - administration & dosage; Cyclosporine - adverse effects; Female; Humans; Immunosuppressive Agents - administration & dosage; Immunosuppressive Agents - adverse effects; Keratoconjunctivitis - drug therapy; Male; Middle Aged; Ophthalmic Solutions - therapeutic use; Retrospective Studies; Visual Acuity
• ISSN: 1542-233X
• DOI: 10.1097/ICL.0000000000000099

To evaluate the use of topical cyclosporine A (CSA) 1% in the treatment of chronic follicular conjunctivitis (CFC). Retrospective chart review from 2001 to 2012 identified 12 patients (22 eyes) with CFC (mean ± standard deviation [SD] age, 50.2 ± 15.4 years; 75% female; 92% white) treated with CSA. Main outcome measures included inflammation grade, visual acuity, concurrent corticosteroid (CS) therapy, effect on CS taper, and adverse effects. Mean ± SD follow-up time was 11.7 ± 9.7 months. Mean ± SD time from diagnosis to CSA treatment initiation was 2.4 ± 3.2 months. Mean ± SD duration of CSA treatment was 5.8 ± 2.8 months. Four patients (33%) complained of irritation (n = 2), redness (n = 1), itching (n = 1), and burning (n = 1) but none discontinued treatment. Concurrent CSs were tapered off in all patients after a mean ± SD of 5.0 ± 2.5 weeks. Mean ± SD initial vision was 0.078 ± 0.093 logMAR, whereas vision at final examination was 0.056 ± 0.081 logMAR (P = 0.02). Mean ± SD initial inflammation grade of 1.9 ± 1.0 was significantly reduced to final grade of 0.7 ± 0.9 (P = 0.0002). Mean ± SD time to initial inflammation control in 9 patients (75%) was 33.2 ± 24.5 days. Two patients (17%) switched to oral CSA because of lack of inflammation control. Topical CSA 1% is an effective and well-tolerated therapy that decreased chronic inflammation and tapered topical CS in patients with CFC. The use of CSA in such patients warrants further investigation.