Topical tacrolimus for the treatment of severe allergic keratoconjunctivitis in children

• Autor(a) principal: Liendo, Vera Lucia [UNIFESP]
• Data de Publicação: 2017
• Outros Autores: Vola, Maria Eugenia [UNIFESP], Barreiro, Telma Pereira [UNIFESP], Wakamatsu, Tais Hitomi UNIFESP], Pereira Gomes, Jose Alvaro [UNIFESP], dos Santos, Myrna Serapiao [UNIFESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492017000400211&lng=en&nrm=iso&tlng=en; https://repositorio.unifesp.br/handle/11600/53506
• topic: Cornea; Tacrolimus therapy; Conjunctivitis; Allergic drug therapy

Purpose: Administration of eye drops containing antihistamines or sodium cromoglycate and its derivatives for the treatment of allergic keratoconjunctivitis is often insufficient and usually requires the addition of corticosteroids. However, the risk of complications, such as glaucoma and cataract, limits the use of corticosteroids to short courses, resulting in inadequate long-term treatment response. Immunosuppressive drugs have been considered as a valid alternative to steroids for atopic keratoconjunctivitis and vernal keratoconjunctivitis. This study aimed to evaluate the use of topical tacrolimus (TCL) in improving the clinical signs of severe allergic keratoconjuctivitis in children. Methods: Patients with severe allergic keratoconjunctivitis associated with corneal epitheliopathy, gelatinous limbal infiltrates, and/or papillary reaction, along with a history of recurrences and resistance to conventional topical anti-allergy agents, were included in this open clinical trial. Patients were treated with 0.03% TCL ointment for ocular use. A severity score ranging from 0 to 9, with 9 being the highest and 0 being the lowest, was assigned based on signs observed on biomicroscopy prior to and following TCL treatment. Results: Analyses included 66 eyes of 33 patients. After a mean follow-up period of 13 months (range, 12-29 months), TCL treatment significantly decreased the mean symptom score severity for the right (from 5.56 +/- 1.18 to 2.76 +/- 1.5