<p>Eye drop emulsion containing 0.1% cyclosporin (1 mg/mL) for the treatment of severe vernal keratoconjunctivitis: an evidence-based review and place in therapy</p>

Abstract

Vernal keratoconjunctivitis (VKC) is a rare, recurrent and multifactorial ocular disease, which typically flares up during spring and affects especially male children and adolescents. This condition does not usually respond to common treatments with antihistamines or mast cells stabilizers, whereas corticosteroids have effective results. Corticosteroids need to be carefully administered, to avoid adverse effects, mainly the secondary development of glaucoma, cataracts, or infections. Immunosuppressive agents, such as cyclosporin (CyA) or tacrolimus are, therefore, frequently employed in VKC patients. Only the 0.1% CyA (1 mg/mL) concentration has an approved and specific clinical indication for the treatment of VKC and this drug was given the denomination of orphan drug by the European Commission (EU/3/06/360) in 2006. So far, few studies have been conducted to evaluate the efficacy and the side effects of topical 0.1% CyA. Different topical CyA concentrations, ranging from 0.05% to 2%, and various types of formulation are available at the moment. In the future, 0.1% CyA will presumably take an important part in the management of VKC. The present review focuses on eye drops containing 0.1% CyA; however, more studies will be needed to define its long-term efficacy in the natural course of this severe ocular disease.

The Complex Relationship between Diabetic Retinopathy and High-Mobility Group Box: A Review of Molecular Pathways and Therapeutic Strategies

“…Cyclosporine A is a polypeptide derived from the fungi Beauveria nevus and Tolypocladium inflatum , and it is well known for its anti-inflammatory and immunosuppressive effects [ 130 ]. Wang et al demonstrated that CyA attenuates the enhanced expression of IL-1β and TNF-⍺ in the retinas of diabetic rats, probably via the suppression of HMGB1.…”

A Case of Shield Ulcer Due to Vernal Keratoconjunctivitis

“…Studies have shown that the symptoms and signs of patients treated with 0.1% CsA improved and steroids were stopped in some patients. [7][8] The efficacy of topical CsA in different dosages and installation frequencies has been shown in several studies. Westland and et al reported three patients with shield ulcers due to VKC who responded quickly with complete reepithelialization after adding topical CsA to conventional treatment including steroids.…”

Recent Advances in the Design of Topical Ophthalmic Delivery Systems in the Treatment of Ocular Surface Inflammation and Their Biopharmaceutical Evaluation

“…The adverse effects associated with the use of corticosteroid eye drops are different. These include elevated intraocular pressure and induced glaucoma, cataract formation, delayed wound healing, and increased susceptibility to infection [57]. Furthermore, the most common reported side effect of CsA is ocular burning, reported in 17% of patients, and approximately 3% of patients stop the medication as a result of this side effect [7].…”