Topical treatments for blepharokeratoconjunctivitis in children

O’Gallagher, Michael; Bunce, Catey; Hingorani, Melanie; Larkin, Frank; Tuft, Stephen; Dahlmann‐Noor, Annegret

doi:10.1002/14651858.cd011965

Cited by 4 publications

(5 citation statements)

References 65 publications

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“…Esto se hace con el objetivo de minimizar los efectos adversos de estos medicamentos. Además, se deben llevar a cabo controles frecuentes para monitorear la PIO 12 .…”

Section: Discussionunclassified

“…En lo que respecta a los inhibidores de la calcineurina, su finalidad principal es controlar la inflamación y actuar como un complemento ahorrador de corticosteroides. Se ha estudiado la efectividad de la ciclosporina en diversas concentraciones, así como el tacrolimús, y se ha observado una buena tolerancia y resultados positivos en pacientes con rosácea ocular 12,13 .…”

Section: Discussionunclassified

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Blefaroqueratoconjuntivitis infantil: cuando el diagnóstico tardío amenaza la visión

Bilbao-Robertson,

Berger-Ovalle

2023

IRIS

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La blefaroqueratoconjuntivitis (BKC) es una inflamación crónica de los párpados que afecta a la superficie ocular. En niños, su diagnóstico y tratamiento suelen retrasarse, lo que puede causar complicaciones graves como neovascularización corneal y pérdida de visión. La falta de reconocimiento temprano conduce a derivaciones tardías y subestimación de la necesidad de atención especializada. Paciente de sexo femenino de 11 años, asintomática, que consultó por control refractivo, su agudeza visual mejor corregida fue de 0,3/0,7 en escala Snellen, con una refracción de +3,75 = -4,4 a 170° en ojo derecho (OD) y +1,0 = -5,25 a 5°. Presentaba blefaritis anterior y posterior bilateral, neovasos corneales con infiltrados lipídicos mayor a OD con compromiso de eje visual. Se realizó tratamiento basado en aseo palpebral, corticosteroides y antibióticos tópicos, manejo de rosácea ocular con azitromicina tópica al 1,47% y colonización por Demodex con ivermectina oral. La BKC es una enfermedad oftalmológica subdiagnosticada y subtratada en niños, lo que a menudo conduce a complicaciones severas, como neovascularización corneal. Los niños son especialmente vulnerables a estas complicaciones debido a su impacto en el desarrollo visual normal y el riesgo de ambliopía. El manejo de la BKC se basa en mejorar la función de las glándulas de Meibomio, controlar la colonización bacteriana y de Demodex, reducir la inflamación y usar inmunosupresores cuando sea necesario. Se requiere un enfoque escalonado y prolongado en el tratamiento, con monitoreo frecuente de la presión intraocular.

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“…Esto se hace con el objetivo de minimizar los efectos adversos de estos medicamentos. Además, se deben llevar a cabo controles frecuentes para monitorear la PIO 12 .…”

Section: Discussionunclassified

Blefaroqueratoconjuntivitis infantil: cuando el diagnóstico tardío amenaza la visión

Bilbao-Robertson,

Berger-Ovalle

2023

IRIS

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“…B lepharokeratoconjunctivitis (BKC), one of the most common ocular surface disorders in children, [1][2][3][4][5] is a clinically diagnosed disease that involves acute or chronic inflammation of the eyelids, conjunctiva, and cornea, resulting in corneal opacity, neovascularization, and scarring. 3,4,[6][7][8][9][10][11][12] Because BKC causes various nonspecific symptoms such as ocular irritation, redness, watering, and itching sensation, it is easily overlooked or underdiagnosed in children. 3,4,13,14 Insufficient or delayed treatment of BKC can induce corneal opacity and irregular astigmatism, leading to amblyopia in pediatric patients.…”

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confidence: 99%

“…There is still no high-quality evidence of the safety or efficacy of treatments for pediatric BKC. 6 BKC treatments include topical and/or systemic medications targeting the clearance of meibomian gland secretion, 4,6,7 correction of ocular surface dysbiosis, 1,5,15,16 and reduction of ocular surface inflammation. 1,5,6,[17][18][19][20][21][22][23] Despite treatment, BKC is recurrent and chronic in nature, rendering pediatric patients vulnerable to detrimental and permanent visual impairment.…”

mentioning

confidence: 99%

“…6 BKC treatments include topical and/or systemic medications targeting the clearance of meibomian gland secretion, 4,6,7 correction of ocular surface dysbiosis, 1,5,15,16 and reduction of ocular surface inflammation. 1,5,6,[17][18][19][20][21][22][23] Despite treatment, BKC is recurrent and chronic in nature, rendering pediatric patients vulnerable to detrimental and permanent visual impairment. Thus, long-term observation and management are critical to ensure full visual development in pediatric patients with BKC.…”

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confidence: 99%

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Clinical Characteristics and Therapeutic Outcomes of Pediatric Blepharokeratoconjunctivitis

Moon

Lee

Kim

et al. 2022

Cornea

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Purpose:The purpose of this study was to determine the clinical characteristics, disease course, therapeutic outcomes, and prognostic factors for pediatric patients with blepharokeratoconjunctivitis (BKC).Methods:A retrospective medical chart review was performed for patients aged 15 years or younger who had been diagnosed with BKC between 2004 and 2020 at 2 tertiary hospitals in Korea. The following data were collected: demographics, medical history, ocular findings, geometric profiling of corneal lesion, medical management, and outcomes.Results:A total of 137 patients (90 female and 47 male) were included. The patients’ mean age was 8.3 ± 3.8 years at disease onset. Both eyes were involved in 57.7% of cases. The most common corneal lesion was corneal neovascularization (77.4%), followed by clinically visible corneal infiltration (51.8%) and stromal scarring (43.1%). Most of the corneal lesions involved a single quadrant, most commonly the inferior quadrant. After treatment, disease remission was achieved in 95% of patients, and visual acuities improved from 0.2 ± 0.3 logarithm of minimal angle of resolution at disease presentation to 0.1 ± 0.3 logarithm of minimal angle of resolution at final follow-up (P = 0.001). Recurrence occurred in 52.6% of patients. Cylinder power was significantly higher in patients with recurrence than in those without. The number of cases of recurrence was positively associated with final cylinder power.Conclusions:Although the treatment induced disease remission in 95% of children with BKC, recurrence occurred in 52.6% of those cases. Because recurrence resulted in significant astigmatism, careful observation for recurrence and prompt management are warranted for preservation of vision in pediatric patients with BKC.

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