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Systemic treatment for blepharokeratoconjunctivitis in children.

Michael O'Gallagher1, Marina Banteka, Catey Bunce

  • 1Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London, UK, EC1V 2PD.

The Cochrane Database of Systematic Reviews
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No clinical trials currently exist for systemic treatments for blepharokeratoconjunctivitis (BKC) in children. Further research is needed to establish the safety and efficacy of these treatments for BKC.

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Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology

Background:

  • Blepharokeratoconjunctivitis (BKC) is an inflammatory eye condition affecting eyelids and ocular surface, potentially causing vision loss in children.
  • Chronic BKC can lead to corneal scarring, opacity, and vision impairment due to corneal opacity, refractive error, or amblyopia.
  • Current BKC management targets meibomian gland dysfunction, bacterial flora, and ocular inflammation, with dietary modifications like essential fatty acid (EFA) intake also considered beneficial.

Purpose of the Study:

  • To assess and compare the efficacy and safety of systemic treatments for BKC in children aged 0-16 years.
  • Systemic treatments evaluated include antibiotics, nutritional supplements, and immunosuppressants, administered alone or in combination.
  • The review focused on identifying randomized controlled trials (RCTs) for systemic interventions in pediatric BKC.

Main Methods:

  • A comprehensive literature search was conducted across multiple databases including CENTRAL, MEDLINE, EMBASE, ISRCTN, ClinicalTrials.gov, and WHO ICTRP.
  • Searches covered literature from January 1946 to April 2016 without date or language restrictions.
  • Randomized controlled trials (RCTs) involving children (0-16 years) with a clinical diagnosis of BKC and receiving systemic treatments were sought.

Main Results:

  • No randomized controlled trials (RCTs) met the inclusion criteria for this Cochrane review.
  • There is a significant lack of clinical trial data on the efficacy and safety of systemic treatments for BKC in children.
  • Standardized outcome measures for evaluating BKC treatments are currently lacking.

Conclusions:

  • Currently, there is no clinical trial evidence to support the safety or efficacy of systemic treatments for BKC in children.
  • There is a critical need for well-designed clinical trials to evaluate current and future systemic treatments for BKC.
  • Development of standardized outcome measures, encompassing both objective clinical findings and patient-reported outcomes, is essential for future research.