Posters

Topical Tacrolimus for the treatment of corneal subepithelial infiltrates after adenoviral keratoconjunctivitis refractory to topical steroids and cyclosporine

Poster Details

First Author: A.Garde SPAIN

Co Author(s):    J. Artaechevarria   J. San Roman   B. Garcia Sandoval   N. Alejandre   I. Jiménez-Alfaro        

Abstract Details

Purpose:

To evaluate the safety and efficacy in terms of visual acuity and ocular symptoms of topical 0.03% tacrolimus eye drops in a series of 23 patients that presented post adenoviral corneal subepithelial infiltrates with a negative response to topical steroids and/or cyclosporine

Setting:

The tertiary referral University Hospital Fundación Jiménez Díaz, Madrid, Spain

Methods:

A retrospective study that included patients evaluated in our hospital with corneal subepithelial infiltrates (SEI) due to previous adenoviral keratoconjunctivitis, who showed no response to topical corticoid or cyclosporine treatment. A total of 38 eyes from twenty-three patients were included. Topical 0.03% tacrolimus was administered twice a day, during a mean time of 5 months. An informed consent about the off-label use of 0.03% tacrolimus was obtained in all patients. Follow-up time varied from 4 to 16 months. Complete ophthalmological evaluation was performed previously and during follow-up, which included ocular symptoms, visual acuity, iconography and anterior segment-OCT

Results:

Topical 0.03% tacrolimus presented good tolerance overall (95.7%), despite the complaints about the itchiness during the first days (60%). Only one patient stopped treatment due to bad tolerance (4.3%). Visual acuity (56.25%) and ocular symptoms improved in patients that received topical tacrolimus, with better results concerning the glare and dysphotopsies (91.3%). Number and size of SEIs was reduced in all patients, objectivized with photographies and AS-OCT. In 3 patients (13%) topical tacrolimus was reintroduced due to the SEIs recurrence. In two of these patients (8.7%), the duration of tacrolimus therapy had been shorter (two months), due to a bad compliance

Conclusions:

In our experience, topical tacrolimus 0.03% bd. is a safe and effective treatment, with a very positive tolerance, for the treatment of corneal subepihelial infiltrates after adenoviral keratoconjunctivitis, even when previous treatments with corticoids or ciclosporine had failed. The effectiveness of the treatment was also noticed in patients with a long evolution of the SEIs (even more than two years) before starting the tacrolimus treatment. Further studies with larger number of patients and longer follow-ups should be performed in order to demonstrate these findings, and to evaluate the long-term effectivity of this therapy

Financial Disclosure:

None