Systemic interventions for severe atopic and vernal keratoconjunctivitis in children and young people up to the age of 16 years

Kim, Soyang Ella; Quartilho, Ana; Larkin, Frank; Hingorani, Melanie; Tuft, Stephen; Dahlmann‐Noor, Annegret

doi:10.1002/14651858.cd013298

Cited by 6 publications

(7 citation statements)

References 50 publications

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“…VKC differs clinically according to geographical region. [11] In middle eastern countries with warm climate VKC has a higher prevalence, [4] and in Israel, we nd a perennial course to be common in contrast to the seasonal characteristic in other climates.…”

Section: Introductionmentioning

confidence: 66%

“…[14] No scoring system has been shown to be superior or more credible than others. [4] The variability of treatment choices and the lack of a standardized treatment protocol leads to prolonged treatment periods, various attempts of different medications, relapse episodes and added emotional and physical stress on the child and parents. Patients were divided by severity and treated according to our treatment protocol based on clinical judgment as discussed earlier.…”

Section: Discussionmentioning

confidence: 99%

“…[1] The typical clinical course is characterized by seasonal exacerbations, but up to 23% can entail perennial symptoms that can recur throughout the year. [2][3][4] The diagnosis of VKC is based on the patient's clinical history and symptoms. There is no consensual grading system, and several scales have been developed with emphasis on severity of symptoms from no in ammatory changes to severe changes.…”

Section: Introductionmentioning

confidence: 99%

“…There is no consensual grading system, and several scales have been developed with emphasis on severity of symptoms from no in ammatory changes to severe changes. [4] The most common symptoms of VKC are itching, photophobia, burning, and tearing. [5] Other symptoms are foreign body sensation and pain upon wakening.…”

Section: Introductionmentioning

confidence: 99%

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When To Start Tacrolimus Ointment For Vernal Keratoconjunctivitis? A Proposed Treatment Protocol

Arnon

Knisbacher

Yahalomi

et al. 2021

Preprint

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PurposeThe aim of this study was to compare treatment regimens of tacrolimus and of topical steroids for VKC and suggest a treatment protocol according to our clinical experience.MethodsThis retrospective, nonrandomized case series enrolled 85 Patients with VKC. Patients were classified clinically according to severity (mild, moderate, severe) and were treated according to a suggested protocol. Analysis was made according to treatment received: tacrolimus ointment as first line treatment (tacrolimus 1st line), tacrolimus ointment after topical steroid drops treatment (tacrolimus 2nd line) and topical steroid drops or artificial tears alone (topical steroid and tears group). Results Significant improvements in clinical signs and symptoms were achieved under tacrolimus treatment 14 months in the moderate group and 5 months in the severe group. The longest duration of treatment was for tacrolimus 2nd line group (p=0.031) and the mean number of visits in the clinic was the highest. The mean number of topical treatments per day was higher in the topical steroid and tears group (2.6 times) than in the two tacrolimus groups (1.3 times for both). The mean time needed to achieve disease remission or relief did not differ between the tacrolimus 1st line and 2nd line groups.ConclusionTacrolimus treatment is effective and safe for VKC. Tacrolimus as 1st line treatment may be preferred for severe cases, for faster disease remission compared to tacrolimus as 2nd line treatment; and with fewer topical treatments per day compared to topical steroids.

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Section: Introductionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

When To Start Tacrolimus Ointment For Vernal Keratoconjunctivitis? A Proposed Treatment Protocol

Arnon

Knisbacher

Yahalomi

et al. 2021

Preprint

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show abstract

“…A multi‐disciplinary approach would therefore be ideal. Yet surprisingly little high‐quality evidence is available about efficacy and safety of topical and systemic treatments for AKC and VKC 2 …”

Section: Introductionmentioning

confidence: 99%