Topical Cyclosporine in the Management of Shield Ulcers

Abstract

Topical cyclosporine is an effective treatment alternative in the management of shield ulcers in patients with vernal keratoconjunctivitis. The 1% concentration seems to be the minimal effective concentration in such cases in our experience, but further controlled studies are needed to support our findings.

Rapid Healing of Vernal Shield Ulcer After Surgical Debridement

“…6 Generally, first-line management is medical therapy, including topical antihistamines, mast cell stabilizers, and corticosteroids. Supratarsal steroid injection, 7 cryotherapy, 8 systemic aspirin, 9 topical mitomycin C, 10 and topical cyclosporine A 11 have all been tried in the management of VKC.…”

Modern Approach to Managing Vernal Keratoconjunctivitis

“…Topical cyclosporine helps in the healing of vernal shield ulcers, but recurrences may occur at lower concentrations and can be treated by increasing the concentration [39]. Off-label use of commercial preparation of cyclosporine (0.05%) eyedrops, recommended for the treatment of dry eye, decreased the symptoms and signs of VKC [40].…”

Ocular Allergy

“…Cyclosporine A (CsA) 1 % or 2 % emulsion in castor or olive oil can be considered for treatment of severe VKC and can serve as a good alternative to steroids [ 7 , 25 , 43 , 47 , 49 ]. Cyclosporine 1 % was reported to be the minimum effective concentration in the treatment of vernal shield ulcer, with recurrence observed at lower concentrations [ 12 ]. In a randomized, controlled trial, the effects of 0.05 % topical cyclosporine were similar to placebo in the treatment of VKC [ 15 ].…”