Topical tacrolimus for the treatment of severe allergic keratoconjunctivitis in
            children

Liendo, Vera Lucia; Vola, Maria Eugenia; Barreiro, Telma Pereira; Wakamatsu, Tais Hitomi; Gomes, José Álvaro Pereira; Santos, Myrna Serapião dos

doi:10.5935/0004-2749.20170052

Cited by 17 publications

(13 citation statements)

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“…Though uncertainty exists about its mechanism of action but it is known to interact with 12-kDa FK506-binding protein in T-cells and thus inhibits calcineurin activity that ultimately leads to reduced de-phosphorylation of the nuclear factor of activated T-cells and hence TH1 (IL-2, interferon-γ), as well as TH2 cytokines (IL-4, IL-5) production is reduced 8 . Tacrolimus is also known to inhibit histamine release from mast cells thus alleviating the symptom of itching 9 .…”

mentioning

confidence: 99%

Efficacy of 0.03% Dermatological Tacrolimus Ointment for Refractory Vernal Keratoconjunctivitis.

Imtiaz

Qayyum²,

Iqbal³

et al. 2020

pak J Ophthalmol

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Purpose: To determine the efficacy of 0.03% dermatological tacrolimus ointment in patients with refractory vernal keratoconjunctivitis Study Design: Quasi-experimental study Study Place and Duration: Eye Department, DHQ-Teaching Hospital, Gujranwala, Pakistan from April 2018 to March 2019 Material and Methods: After approval from hospital ethical committee and obtaining written informed consent from each patient/guardian, patients of either gender between 4-16 years of age with VKC not responding to conventional treatment for more than 8 weeks or having steroid-induced complications were included in this study. Dermatological tacrolimus ointment 0.03% started to be placed in inferior fornix in BD frequency along with topical lubricants. Patients were followed up on a regular schedule. Individual symptoms score was assessed from the questionnaire and signs score from observer’s clinical assessment. Data were analyzed using SPSS v23.0. P-value <0.05 was considered as statistically significant. Results: 40 eyes of 20 patients were included in this study. Out of which 4(20%) were female and 16 were male (80%). Mean baseline score for clinical symptoms was 6.65±1.81 that reduced to 1.65±0.81 after 12 weeks treatment course of tacrolimus with a significant p-value of 0.006 (p<0.05). Mean baseline score for clinical signs was 5.9±1.59 that improved to 1.80±0.83 after 12 weeks treatment course with a statistically significant p-value of 0.003 (p<0.05). Conclusions: In conclusion, topical tacrolimus dermatological ointment 0.03% is highly effective in refractory VKC and can be safely used as an alternative in VKC patients who are steroid-responders.

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confidence: 99%

Efficacy of 0.03% Dermatological Tacrolimus Ointment for Refractory Vernal Keratoconjunctivitis.

Imtiaz

Qayyum²,

Iqbal³

et al. 2020

pak J Ophthalmol

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“…Conjunctival epithelial cells were sampled from the more severely affected eye defined by a clinical evaluation of signs and symptoms of ocular allergy 20. Nine healthy volunteers with no history of ocular or systemic allergic disease or history of drug or contact lens use were recruited from the community of the UNIFESP to the study as a control group.…”

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confidence: 99%

Galectin-3: role in ocular allergy and potential as a predictive biomarker

et al. 2018

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“…It is prescribed in cases of keratoconjunctivitis as a steroid‐sparing treatment. Other treatments, such as local tacrolimus, have been tried in selected cases . Biotherapies (omalizumab, dupilumab) are currently under study .…”

Section: Treatmentmentioning

confidence: 99%

“…Other treatments, such as local tacrolimus, have been tried in selected cases. 33 Biotherapies (omalizumab, dupilumab) are currently under study. 34 In complicated forms of VKC and AKC, the ophthalmologist can decide on urgent surgical treatments such as supratarsal injection of steroids, abrasion of a vernal plaque or application of an amniotic membrane graft to heal a corneal ulcer.…”

Section: Tre Atmentmentioning

confidence: 99%

Diagnosing and managing allergic conjunctivitis in childhood: The allergist’s perspective

Fauquert

2019

Pediatric Allergy Immunology

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Allergic conjunctivitis in childhood often poses problems of diagnosis and management for the allergist. We present the salient points concerning the diagnosis and treatment of ocular allergy emerging from a large cohort survey conducted jointly in the departments of ophthalmology and paediatric allergy in a French teaching hospital. Seasonal acute conjunctivitis is a common disorder and not overly difficult to diagnose and treat when associated with rhinitis leading to allergic rhinoconjunctivitis. An ophthalmologist should be consulted when conjunctivitis occurs alone and if another form of conjunctivitis is suspected, such as perennial allergic conjunctivitis, vernal keratoconjunctivitis or atopic keratoconjunctivitis. When IgE‐mediated hypersensitivity assessment does not establish aetiological diagnosis, a conjunctival allergen provocation test can be performed. The principal non‐IgE‐mediated allergy is chronic blepharoconjunctivitis. The main problem for differential diagnosis is the presence of signs suggestive of dry eye. Management includes non‐pharmacological treatments, such as lacrimal substitutes, avoidance measures and protection of the ocular surface. Second‐line treatment consists of eye drops, preferably single dose or without additives and with dual local action, mast cell stabilizer action and antihistaminic action. Third‐line treatment is reserved for severe forms. Short‐lasting local steroid therapy can control flare‐ups of allergic keratoconjunctivitis, which should have specialized follow‐up. Cyclosporine is a disease‐modifying treatment, which is both effective and well tolerated.

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Topical tacrolimus for the treatment of severe allergic keratoconjunctivitis in children

Abstract: Topical TCL was effective and significantly improved the clinical signs of allergic keratoconjuctivitis in children. Thus, it is a potential new option for severe and challenging cases of ocular allergy.

Cited by 17 publications

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Efficacy of 0.03% Dermatological Tacrolimus Ointment for Refractory Vernal Keratoconjunctivitis.

Efficacy of 0.03% Dermatological Tacrolimus Ointment for Refractory Vernal Keratoconjunctivitis.

Galectin-3: role in ocular allergy and potential as a predictive biomarker

Diagnosing and managing allergic conjunctivitis in childhood: The allergist’s perspective

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