Published date:Oct 24 2019

Journal Title: Journal of Ophthalmic and Vision Research

Issue title: October–December 2019, Volume 14, Issue 4

Pages:412 – 418

DOI: 10.18502/jovr.v14i4.5439

Arkendu ChatterjeeNRS Medical College & Hospital, Kolkata, India

Sabyasachi Bandyopadhyaysabyasachi.bandyopadhyay@yahoo.comR.G.Kar Medical College & Hospital, Kolkata, India

Samir Kumar BandyopadhyayNRS Medical College & Hospital, Kolkata, India

Purpose: 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).

Methods: 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 followup visit. The intraocular pressure (IOP) measurement and evaluation of any ocular side effects were carried out.

Results: Significant reduction in symptom score and sign score was seen in both groups. Cs A group significantly showed more reduction in symptom (P < 0.0001 in all follow-up visits) and sign (P < 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 (P < 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.

Conclusion: Topical Cs A 0.05% is effective and safe in patients with moderate to severe VKC with good steroid-sparing effect.

Keywords: Allergic Conjunctivitis, Intraocular Pressure, Topical Cyclosporine A, Topical Loteprednol Etabonate, Vernal Keratoconjunctivitis

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