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Pediatric Ocular Rosacea: Clinical Features and Long-Term Maintenance Therapy with Topical Cyclosporine
Gamze Özkan1, Gizem Doğan Gökçe2, Semra Akkaya Turhan3
1Department of Ophthalmology, Bitlis State Hospital, Bitlis, Turkey.
Insights
Topical cyclosporine maintenance therapy significantly improved vision, reduced ocular surface inflammation, and stabilized tear film in pediatric ocular rosacea patients. This treatment offers a promising approach for managing this condition in children.
Area of Science:
- Ophthalmology
- Pediatric Dermatology
- Immunology
Background:
- Pediatric ocular rosacea (OR) is a chronic inflammatory condition affecting the ocular surface and eyelids.
- Management often involves addressing inflammation, tear film instability, and potential visual impairment.
- Long-term therapeutic strategies for pediatric OR require evaluation for efficacy and safety.
Purpose of the Study:
- To assess the clinical presentation, visual outcomes, meibography, and non-invasive tear break-up time (NIBUT) in pediatric OR patients.
- To evaluate the effectiveness of topical 0.05% cyclosporine as maintenance therapy for pediatric ocular rosacea.
Main Methods:
- Retrospective study of pediatric patients (<16 years) diagnosed with ocular rosacea.
- Analysis of demographic data, corneal involvement, diagnostic delays, and recurrence rates.
- Evaluation of best-corrected visual acuity (BCVA), refractive error, meibography, and NIBUT before and after treatment with topical cyclosporine maintenance therapy.
Main Results:
- Twenty-two patients (mean age 7.6 years) were included with a mean follow-up of 23.8 months.
- Corneal involvement was observed in 20 patients; delayed diagnosis occurred in 10.
- Topical cyclosporine treatment led to improved BCVA, reduced astigmatism, decreased meibomian gland loss, and improved NIBUT.
Conclusions:
- Long-term maintenance therapy with topical cyclosporine is effective in improving visual outcomes in pediatric ocular rosacea.
- Cyclosporine therapy helps reduce ocular surface inflammation and stabilizes the tear film in this patient population.
- This approach offers a valuable strategy for managing pediatric ocular rosacea and its associated complications.
Purpose:
To evaluate the clinical presentations, visual outcomes, meibography, and non-invasive tear break-up time (NIBUT) findings in pediatric ocular rosacea (OR) patients receiving maintenance therapy with topical cyclosporine.
Methods:
This retrospective study reviewed medical records of patients under 16 years diagnosed with OR. Demographic characteristics, corneal involvement, delayed diagnosis, and recurrence rates were assessed. Best-corrected visual acuity (BCVA), cylindrical value, meibography findings, and NIBUT were evaluated at presentation and the final visit. During the acute phase, all patients received artificial tear, topical antibiotic, topical steroid, and systemic azithromycin. For maintenance therapy, topical 0.05% cyclosporine drops were used.
Results:
There were 22 patients with a mean age of 7.6 ± 3.4 years. The mean follow-up time was 23.8 ± 9.9 months. Seven patients had skin involvement. Corneal involvement with was present in 20 out of 22 patients. Delayed diagnosis was present in 10 patients, with a mean delay duration of 10.0 ± 2.7 months. Two patients showed recurrence and mean recurrence time was 6.50 ± 2.50 months. The BCVA of eyes with poorer vision improved compared to the initial presentation (0.34 ± 0.27 logMAR) at the last visit (0.02 ± 0.04 logMAR). The cylindrical value of the eyes with poorer vision decreased at the last visit (-2.21 ± 1.33 D) compared to baseline. The rate of MG loss in both upper and lower eyelids decreased with treatment and NIBUT improved.
Conclusion:
This retrospective case series suggests that long-term maintenance therapy with topical cyclosporine, improves visual outcomes, reduces ocular surface inflammation and stabilizes the tear film in pediatric patients with OR.
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