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Topical cyclosporine A in severe steroid-dependent childhood phlyctenular keratoconjunctivitis

Serge Doan1, Eric Gabison, Damien Gatinel

  • 1Service d'ophtalmologie, Hôpital Bichat, Fondation A. de Rothschild, 46 rue Henri Huchard, 75018 Paris, France. serge.doan@noos.fr

American Journal of Ophthalmology
|January 3, 2006
PubMed

Insights

Topical cyclosporine A (CsA) effectively treated severe corneal inflammation in children with phlyctenular keratoconjunctivitis. This steroid-sparing therapy demonstrated good local tolerance and prevented recurrence in most cases.

Area of Science:

  • Ophthalmology
  • Immunology

Background:

  • Phlyctenular keratoconjunctivitis (PKC) in children can cause severe, steroid-dependent corneal inflammation.
  • Standard treatments may be insufficient for severe cases, necessitating alternative therapeutic approaches.

Purpose of the Study:

  • To evaluate the efficacy and safety of topical cyclosporine A (CsA) for treating pediatric PKC with severe corneal inflammation.
  • To assess CsA's role as a steroid-sparing agent in this challenging condition.

Main Methods:

  • A prospective, noncomparative interventional case series involving 11 children (13 eyes) with severe steroid-dependent PKC.
  • Treatment involved topical CsA 2% four times daily, with initial short-term combination with topical dexamethasone.
  • Efficacy was assessed by patient-reported symptoms and ophthalmologist evaluations of ocular redness and corneal inflammation.

Main Results:

  • Complete control of corneal inflammation was achieved in all eyes within 14 days of initiating topical CsA therapy.
  • No recurrences of inflammation were observed during CsA monotherapy or after discontinuation in most patients.
  • Topical CsA exhibited good local tolerance, with no detectable systemic absorption and minimal adverse effects.

Conclusions:

  • Long-term topical CsA 2% therapy is a safe and effective treatment for children with phlyctenular keratoconjunctivitis and severe steroid-dependent corneal inflammation.
  • CsA offers a promising steroid-sparing option, reducing the need for prolonged corticosteroid use and its associated complications.
Abstract

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