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[Local cyclosporin A in nummuli after keratoconjunctivitis epidemica. A pilot study]
T Reinhard1, E Godehardt, H G Pfahl
1Augenklinik der Heinrich-Heine-Universität, Moorenstrasse 5, 40225 Düsseldorf. reinhath@uni-duesseldorf.de
Background:
Recurrences are common after discontinuing topical steroids against nummular infiltrates following adenoviral keratoconjunctivitis (AK). To avoid the potentially serious side effects of resumed steroid treatment at increased doses we tested topical 2% cyclosporin A (CSA).
Patients:
We applied four drops of CSA daily to 70 eyes (48 patients) with persistent nummular infiltrates after AK. Treatment began 18.5 months (3-72) after the acute phase of AK. Dose reduction depended on resolution of the nummuli in the individual patients.
Results:
Of the 70 eyes 40 responded positively to therapy, 16 showed no change, therapy was stopped in 4 because of ocular discomfort (burning), and in 10 eyes follow-up is still less than 3 months.
Conclusions:
CSA was effective in eliminating or reducing nummuli in the majority of patients. More than one-half of the responding eyes had a complete cure and did not experience recurrences after stopping therapy. We therefore consider topical CSA to be a safe and effective alternative to topical steroids for treating nummular infiltrates after AK.