Comparative Evaluation of Tacrolimus Versus Interferon Alpha-2b Eye Drops in the Treatment of Vernal Keratoconjunctivitis: A Randomized, Double-Masked Study

Zanjani, H A; Aminifard, Mohammad Naim; Ghafourian, Abdolhossein; Pourazizi, Mohsen; Maleki, Alireza; Arish, Mohammed; Shahrakipoor, Mahnaz; Rohani, Mohammad Reza; Abrishami, Mojtaba; Zare, Ehsan; Jalali, Farhad

doi:10.1097/ico.0000000000001200

Cited by 34 publications

(46 citation statements)

References 23 publications

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“…All of the patients with tacrolimus showed improvement of subjective symptoms while one patient treated with interferon had persistent symptoms. 30 …”

Section: Treatmentmentioning

confidence: 99%

Vernal keratoconjunctivitis

Addis¹,

Jeng²

2018

OPTH

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Vernal keratoconjunctivitis (VKC) is a chronic allergic conjunctivitis that is most often seen in young, males. Although most types of allergic conjunctivitis do not affect vision, VKC is unusual in that damage to the cornea from the condition can result in vision loss. Although it is typically seasonal, year-round symptoms can be seen, which can lead to uncertain diagnoses being made. Although the pathophysiology of VKC is better understood in recent years, allowing more targeted therapies, management of these patients can still be very challenging, and complications can occur. As such, aggressive management of VKC is necessary, especially since vision loss in the amblyogenic age range can be permanent.

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“…All of the patients with tacrolimus showed improvement of subjective symptoms while one patient treated with interferon had persistent symptoms. 30 …”

Section: Treatmentmentioning

confidence: 99%

Vernal keratoconjunctivitis

Addis¹,

Jeng²

2018

OPTH

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“…Five articles were eventually included after the screening based on the established inclusion and exclusion criteria. [12][13][14][15][16] Figure 1 shows the flow chart of literature screening from this meta-analysis.…”

Section: Search Resultsmentioning

confidence: 99%

Therapeutic efficacy of tacrolimus in vernal keratoconjunctivitis: a meta-analysis of randomised controlled trials

Zhao

Yang

et al. 2020

Eur J Hosp Pharm

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Background and objective Tacrolimus has been widely used in recent years for treating allergic conjunctivitis, but there is currently no available metaanalysis regarding its therapeutic efficacy. This study systematically evaluated the effectiveness of tacrolimus in the treatment of allergic conjunctivitis. Methods Data obtained from literature searches of the PubMed, Cochrane Library, Embase, CNKI, and Wanfang databases were retrieved by combining medical subject words and free words. Literature was selected on the basis of established inclusion and exclusion criteria, and the extracted data were evaluated for risk of bias using RevMan 5.3 for meta-analysis. Results A total of 177 articles were retrieved, of which 5 articles were eventually selected, all of which involved tacrolimus treatment for vernal keratoconjunctivitis. A total of 203 samples were analysed. Results of the meta-analysis showed that the tacrolimus treatment group had significantly lower ocular objective sign scores (SMD −1.39, 95% CI −2.50 to −0.27; p<0.05) and had a significantly lower subjective symptom evaluation score (SMD −0.92, 95% CI −1.59 to −0.24; p<0.05) than the control group. Conclusion Current evidence shows that tacrolimus is effective in treating vernal keratoconjunctivitis. RESEARCH METHODS This meta-analysis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. 11

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“…Thus, VEGF becomes a potential marker for the disease and/or its severity. It is our aim to cover in a future study how the tear levels of such a mediator could possibly be modified before and after treatment with therapeutic ocular drops [ 4 , 18 – 21 ]. When evaluating blood samples, the difference was not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

Vascular Endothelial Growth Factor (VEGF) Serological and Lacrimal Signaling in Patients Affected by Vernal Keratoconjunctivitis (VKC)

Nebbioso

Iannaccone

Duse

et al. 2018

Journal of Ophthalmology

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Background Vernal keratoconjunctivitis (VKC) is a rare inflammatory disease involving the ocular surface, with seasonally exacerbated symptoms. Both type-1 and type-4 hypersensitivity reactions play a role in the development of VKC. Purpose The aim of the present study was to assess the presence and evaluate the concentration of the vascular endothelial growth factor (VEGF) in tear and blood samples from patients with VKC, during the acute phase, based on the histopathological vasculostromal structure of the tarsal papillae. Methods Two groups of children aged between 6 and 16 years of life were enrolled: 21 patients (16 males, 76%) affected by VKC, tarsal or mixed form, and 13 healthy children (5 males, 38%) used as controls. Blood and tear samples were obtained from all patients, in order to specifically assess the presence of VEGF. Statistical analyses were performed with one-way ANOVA, followed by post hoc comparisons with the Bonferroni tests. Pearson's correlation was chosen as statistical analysis to assess the relationship between the expression levels of VEGF in tears and blood and the clinical parameters measured. Results Comparing the 2 groups for VEGF concentration, a statistically significant difference was found in tear samples: the mean value was 12.13 pg/mL (±5.54 SD) in the patient group and 7 pg/ml (±4.76 SD) in controls (p < 0.05). However, no statistically significant difference was found when comparing VEGF concentration in blood samples (p > 0.05), with a mean value of 45.17 pg/mL (±18.67 SD) in VKC patients and 38.08 pg/mL (±19.43 SD) in controls. Conclusions This pilot study highlights the importance of lacrimal and vascular inflammatory biomarkers that can be detected in VKC patients during the acute phase, but not in healthy children. The small group of patients warrants additional studies on a larger sample, not only to further investigate the role of VEGF but also to evaluate the angiogenic biomarkers before and after topical treatment.

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Comparative Evaluation of Tacrolimus Versus Interferon Alpha-2b Eye Drops in the Treatment of Vernal Keratoconjunctivitis: A Randomized, Double-Masked Study

Abstract: This study indicated that both 0.005% tacrolimus and IFN alpha-2b are effective and appear to be safe in treatment of recalcitrant VKC.

Cited by 34 publications

References 23 publications

Vernal keratoconjunctivitis

Vernal keratoconjunctivitis

Therapeutic efficacy of tacrolimus in vernal keratoconjunctivitis: a meta-analysis of randomised controlled trials

Vascular Endothelial Growth Factor (VEGF) Serological and Lacrimal Signaling in Patients Affected by Vernal Keratoconjunctivitis (VKC)

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