To Evaluate Efficacy of Cyclosporine 0.1% Eye Drops as Maintenance Therapy in Patients of Allergic Conjunctivitis

Abstract

BACKGROUND About 20-30% of world population is affected with allergic conjunctivitis. Topical steroids are considered as the mainstay of treatment for severe allergic conjunctivitis. However, steroids are associated with rise in intraocular pressure with subsequent glaucoma, cataract formation and increased susceptibility to microbial infections. This has produced a need to look for other options to treat allergic conjunctivitis. Cyclosporine appears to be a good candidate as it inhibits T-cell inhibition which is an important component of ocular surface inflammation. Aims and Objectives-To evaluate the efficacy and safety of cyclosporine 0.1% eye drops as maintenance therapy in patients of allergic conjunctivitis. MATERIALS AND METHODS This uncontrolled clinical trial study was conducted on 50 patients suffering from mild to moderate allergic conjunctivitis attending the Eye OPD of Government Medical College, Jammu who were receiving the treatment in the form of steroid (loteprednol) eyedrops and had shown improvement with control of both signs as well symptoms of allergy. These patients were put on cyclosporine 0.1% eye drops after stopping the previous medication and evaluated for signs and symptoms at baseline (day 0), 2 weeks, 4 weeks and 12 weeks. RESULTS Out of 50 patients, 2 patients were lost to follow-up after 2 nd week, 4 patients had to be shifted to steroids due to worsening of disease after 2 nd and 4 th week. Remaining 44 patients completed the study with male to female ratio of 1.75:1. All symptoms like itching, discharge, photophobia and watering showed significant improvement at 12 th week as compared to baseline. Signs of conjunctival hyperemia and papillary hypertrophy showed significant reduction from 4 th week onwards and were maximum at 12 th week. The other two signs of Horner Trantas spots and punctate keratitis also showed improvement, but it was not significant as compared to baseline scores. CONCLUSION Topical cyclosporine 0.1% eye drops can be used to control and improve signs and symptoms of allergic conjunctivitis after the acute phase has been treated with steroids. Also, cyclosporine is safe for topical use.