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Systemic cyclosporin A in severe atopic keratoconjunctivitis
Kurt Spiteri Cornish1, Maria Elena Gregory, Katheravelu Ramaesh
1Tennent Institute of Ophthalmology, Glasgow, UK. kurtsc01@yahoo.co.uk
European Journal of Ophthalmology
|May 22, 2010
Summary
Systemic cyclosporin A (CSA) effectively treated severe atopic keratoconjunctivitis (AKC) resistant to conventional therapies. This immunosuppressive treatment improved ocular and dermatologic symptoms, preserving vision with few side effects.
Area of Science:
- Ophthalmology
- Immunology
- Dermatology
Background:
- Severe atopic keratoconjunctivitis (AKC) poses a risk of blindness and is often resistant to standard topical treatments.
- T lymphocytes play a key role in the pathogenesis of AKC and associated atopic dermatitis.
Observation:
- A retrospective case series evaluated 8 patients with severe AKC unresponsive to conventional therapies.
- These patients were treated with systemic cyclosporin A (CSA).
Findings:
- Systemic CSA demonstrated efficacy as a steroid-sparing agent, allowing corticosteroid cessation in 50% of patients.
- Significant improvements were observed, including resolution of papillary blepharoconjunctivitis, punctate keratopathy, and corneal ulcers.
- All patients experienced AKC remission, improved visual acuity, and controlled coexistent atopic dermatitis with minimal side effects.
Implications:
- Systemic CSA is a safe and effective treatment option for severe, refractory AKC.
- This approach can help preserve vision in patients with severe ocular manifestations of atopic disease.
- Findings support the use of systemic CSA for both ocular and dermatologic symptoms in severe atopic conditions.
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