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Systemic Treatment With Cyclosporine A in Children With Severe Vernal Keratoconjunctivitis
Inbal Gazit1,2, Orly Wussuki-Lior1,2, Tsivia Tauber3,2
1Department of Ophthalmology, Shamir Medical Center, Zerifin, Israel.
Insights
Systemic cyclosporine effectively treated severe vernal keratoconjunctivitis (VKC) in children unresponsive to other therapies. This steroid-sparing approach improved quality of life without significant side effects.
Area of Science:
- Ophthalmology
- Immunology
Background:
- Severe vernal keratoconjunctivitis (VKC) poses a significant challenge in pediatric patients.
- Refractory VKC often requires aggressive management due to its debilitating nature and impact on quality of life.
Purpose of the Study:
- To evaluate the efficacy and safety of systemic cyclosporine for severe pediatric VKC.
- To assess its role as a steroid-sparing agent in non-responsive VKC cases.
Main Methods:
- Retrospective analysis of 6 pediatric VKC patients (ages 4-15) treated with systemic cyclosporine.
- Patients had previously failed antihistamines, topical steroids/cyclosporine, and systemic steroids.
- Treatment duration averaged 18 months; outcomes assessed via clinical examination and quality of life surveys.
Main Results:
- Significant improvement in VKC signs and symptoms within 2-4 weeks of systemic cyclosporine initiation.
- All patients achieved steroid-free status and reported enhanced quality of life.
- No significant adverse events were documented during the treatment period.
Conclusions:
- Systemic cyclosporine offers a safe and effective therapeutic option for severe pediatric VKC.
- It acts as a valuable steroid-sparing treatment, improving patient quality of life and maintaining disease quiescence.
Purpose:
To report our experience with systemic cyclosporine as a treatment for severe vernal keratoconjunctivitis (VKC) in pediatric patients who did not respond to previous treatments.
Methods:
We analyzed the medical records of 6 patients, aged 4 to 15 years, with severe VKC treated with systemic cyclosporine for VKC at Shamir Medical Center in Zerifin, Israel, between the years 2000 and 2023. The average treatment duration was 18 months. In all patients, previous treatments with antihistamines, mast cells stabilizers, topical steroids and topical cyclosporine, and systemic steroids did not result in sufficient improvement. The severity of inflammation was evaluated during clinical examinations and the patients' subjective assessment of their quality of life.
Results:
In all 6 patients, signs and symptoms showed significant improvement within 2 to 4 weeks of initiating systemic cyclosporine treatment. All patients were able to discontinue regular steroids use and reported a significant improvement in their quality of life. No significant side effects were observed in any of the patients.
Conclusions:
Systemic cyclosporine is a safe and effective treatment for severe VKC. It is a steroid-sparing treatment that allows good quality of life, while keeping the disease latent.
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