Topical Tacrolimus for Corneal Subepithelial Infiltrates Secondary to Adenoviral Keratoconjunctivitis

Berisa, S; Ayora, Ana C. Riestra; Fernández, Carlos Lisa; Rodríguez, Manuel Chacón; Merayo‐Lloves, Jesús; Sánchez, José F. Alfonso

doi:10.1097/ico.0000000000001279

Cited by 17 publications

(6 citation statements)

References 16 publications

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“…[ 22 23 ] Corticosteroid sparing agents like 0.05%/1% cyclosporine and 0.03% tacrolimus have been studied with significant benefits. [ 24 25 26 27 ] Topical tacrolimus is a safe corticosteroid-sparing agent and with possible benefit in preventing recurrences. [ 27 28 ] In our series, the SEIs following MKC were identical to the ones seen in adenoviral corneal infection.…”

Section: Discussionmentioning

confidence: 99%

“…[ 24 25 26 27 ] Topical tacrolimus is a safe corticosteroid-sparing agent and with possible benefit in preventing recurrences. [ 27 28 ] In our series, the SEIs following MKC were identical to the ones seen in adenoviral corneal infection. In absence of a detailed analysis, our current observed clinical differentiation includes large size (1–1.5 mm), coin or ring shape, significant localized stromal edema, and peripheral location.…”

Section: Discussionmentioning

confidence: 99%

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Sequelae of microsporidial keratoconjunctivitis and its management

Mohanty

Mitra

Mallick

et al. 2021

Indian Journal of Ophthalmology

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Purpose: To characterize the sequelae of microsporidia keratoconjunctivitis (MKC) and outline its management. Methods: Retrospective analysis of microbiologically proven MKC returned with persistent disease between January 2015 and December 2019 was done. Demographics, clinical features, management, and outcome were analyzed. Results: Sixteen patients (21 eyes) of 332 treated for MKC returned with the persisting disease. The mean age of 11 males (68.7%), and 5 females was 35.1 ± 12.2 years. Three-quarter of them did not have a known predisposing risk factor and one-quarter of them were referred for chronic conjunctivitis. Past medications included topical antivirals ( n = 8) and topical corticosteroid ( n = 6). Three predominant presentations were persistent (>3 weeks) superficial punctate keratitis (SPKs, n = 7), sub-epithelial infiltrates (SEIs, n = 13), and uveitis ( n = 2). The lesions recurred in eight eyes (SPK and SEI 4 each) after a disease-free interval of 60.4 ± 40.6 days; there were 13 episodes of recurrence. Topical low potent corticosteroids (loteprednol/fluorometholone), and tacrolimus ointment 0.03% were used in 17 (80.9%) and 8 (38%) eyes, respectively, for a mean duration of 44.8 ± 31.6 and 226.8 ± 180.5 days, respectively. At follow-up, 172.3 ± 183.6 days, visual recovery was statistically significant in persistent eyes (BCVA 0.07 ± 0.07 logMAR; P < 0.00001) but, not in recurrent eyes (BCVA 0.16 ± 0.08 logMAR; P = 0.07). Five of 21 eyes were left with residual significant scar. Conclusion: The sequelae of microsporidial keratoconjunctivitis are not uncommon. Topical 0.03% tacrolimus ointment appeared to be an effective corticosteroid-sparing agent for the treatment of SEIs and prevention of recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sequelae of microsporidial keratoconjunctivitis and its management

Mohanty

Mitra

Mallick

et al. 2021

Indian Journal of Ophthalmology

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“…Prado et al observed a recurrence rate of 18.8% for tacrolimus compounded in pharmacy. [20] The recurrence rate may be significantly high (12.5%) for topical cyclosporine 0.05% therapy. [21]…”

Section: Discussionmentioning

confidence: 99%

Comparison of the safety and efficacy of topical Tacrolimus (0.03%) versus dexamethasone (0.05%) for subepithelial infiltrates after adenoviral conjunctivitis

Bhargava¹,

Kumar²

2019

Indian J Ophthalmol

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Purpose: To compare the safety and efficacy of tacrolimus 0.03% ointment with dexamethasone 0.05% ointment for subepithelial infiltrates (SEIs) following adenoviral keratoconjunctivitis (AK). Methods: A randomized, double blind trial was done. Eligibility criteria was corrected distance visual acuity of 6/9 Snellen or worse for at least 4 weeks with corneal SEIs following AK. The grading of SEIs was done on a scale of 0 to 3; 0, no infiltrates, 1 mild infiltration, 2 moderate infiltration and 3, severe infiltration. Consecutive patients with SEIs following AK were randomized to receive either topical tacrolimus 0.03% or dexamethasone 0.05% ointment twice daily for 6 months. Treatment was successful if there was reduction of SEIs and improvement in vision. Results: A total of 45 patients each were assigned to the Tacro and Dexa groups, respectively. Baseline characteristics of patients did not differ significantly ( P > 0.001). There was a significant change in symptoms, vision and SEIs in both the groups. However, the magnitude was greater in tacro group. Treatment was successful in 37 (92.5%) patients in Tacro and 34 (85%) patients in dexa group. In dexa group, after a period of 1.24 ± 0.24 months, 7 (15.6%) patients developed a significant rise in intraocular pressure (IOP). Three (7.5%) eyes in tacro and 6 (15%) eyes in dexa group had recurrence of SEIs after cessation of therapy. Conclusion: Tacrolimus 0.03% is an effective alternative to dexamethasone 0.05% with low recurrence rate, no significant rise in IOP but may cause burning and foreign body sensation in some patients.

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“…A retrospective study investigated the role of topical tacrolimus in corneal subepithelial infiltrates secondary to adenoviral keratoconjunctivitis management [ 56 ]. Fifty-four eyes (63.5%) and 31 (36.5%) received tacrolimus 0.03% eye drops twice daily and tacrolimus 0.02% ointment once daily.…”

Section: Topical Tacrolimus In Other Anterior Segment Inflammatory Di...mentioning

confidence: 99%

Topical Tacrolimus in Anterior Segment Disorders in Ophthalmology: A Review

2024

RJO

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Topical Tacrolimus for Corneal Subepithelial Infiltrates Secondary to Adenoviral Keratoconjunctivitis

Abstract: Topical tacrolimus, compounded in the pharmacy, seems to be an effective and safe alternative for the treatment of SEIs secondary to adenovirus keratoconjunctivitis.

Cited by 17 publications

References 16 publications

Sequelae of microsporidial keratoconjunctivitis and its management

Sequelae of microsporidial keratoconjunctivitis and its management

Comparison of the safety and efficacy of topical Tacrolimus (0.03%) versus dexamethasone (0.05%) for subepithelial infiltrates after adenoviral conjunctivitis

Topical Tacrolimus in Anterior Segment Disorders in Ophthalmology: A Review

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