Posters

Ocular rosacea: significant improvement after cyclosporin A and bevacizumab treatment – a case report

Poster Details

First Author: K.Bouirig MOROCCO

Co Author(s): K. Bouirig   M. Ez-Zahraoui   A. Ennajar   L. Cherkaoui           

Abstract Details

Purpose:

The diagnosis of ocular rosacea is not always obvious and requires a good analysis of functional and clinical signs. Its etiology remains obscure.

Setting:

Specialty Hospital of Rabat, Morocco Department of Ophthalmology A

Methods:

We report a case  of a 22-year-old patient with recurrent episodes of redness of the eyes and photophobia . who presents  for visual acuity impairment of the right eye .Ophthalmic examination of the same eye shows a best corrected visual acuity at " hand motion", telangiectasias  and meibomitis of the eyelids , perikeratic circle and  corneal neovascularization  extending to the center associated to a  corneal opacity . Examination of the left eye  found a 10/10 BCVA, perikeratic circle,  lower eyelid meibomitis  and  inferio-temporal catarrhal infiltration  with corneal neovascularization .

Results:

The patient was placed on oral cyclins, wetting agents and high dose topical corticosteroid therapy followed by progressive degression and relayed with cyclosporin A  eye drops. She also received two subconjunctival injections of anti-VEGF in the right eye  (Bevacizumab 0.1ml to 25mg / ml). A significant improvement of the functional symptomatology, obvious regression of the corneal nevascularization and decrease in the size of the corneal opacity (Figure 3) with a BAVC (OD) at 4/10, 6 months after the beginning treatment.

Conclusions:

The most common ocular involvement in rosacea is blepharitis, the pathophysiology is poorly understood. An immunological origin can be manifested by an interstitial keratitis producing lower stromal opacities with radially arranged corneal neovascularization , a phlyctenular keratoconjunctivitis, catarrhal infiltration and a pseudo-mooren-type marginal ulcer. Cyclosporin A and subconjunctival injections of anti-VEGF significantly improved the prognosis of complicated forms of ocular rosacea. The evolution of ocular rosacea is chronic and requires prolonged or even permanent treatment. Cyclosporin A as well as subconjunctival injections of anti-VEGF constitute an important therapeutic weapon in the complicated forms of this pathology.

Financial Disclosure:

None