Posters

Omalizumab as an alternative treatment for severe vernal keratoconjunctivitis

Poster Details

First Author: A.Ortiz SPAIN

Co Author(s):    A. Solves   I. Flores   C. Dualde              

Abstract Details

Purpose:

The aim of this study is to update different treatment options for several vernal keratoconjuntivitis. Vernal keratoconjunctivitis is a clinical entity included in the spectrum of allergic diseases. In several cases, vision may be compromised and it is required a prolonged therapy with different drugs. Omalizumab is a humanized monoclonal antibody and could be a hopeful alternative in refractory cases, so we tried to clear up the use and efectiviness of Omalizumab.

Setting:

Hospital Universitario Dr Peset, Valencia, Spain

Methods:

We studied a case of a 12 years old boy suffering severe Vernal Keratoconjunctivitis with none or deficient response to classic treatments approved for the treatment of this pathology. A search of literature was conducted to identify cases of severe vernal and atopic keratoconjunctivitis and to explore the new treatments options. The patient was followed for 26 months by Ophthalmology and Pediatrics departments of our center, with regular medical visits. A register of general and ocular symptoms, data of physical exploration, analytical results, and anterior segment eye photographies were made up.

Results:

The patient presented considerable handicap in his daily life during the follow-up period. He showed typical signs and symptoms including intense ocular perturbances, gigant papillae, Horner-Trantas Dots and recurrent corneal ulcers. Many treatments were set up, including antihistamines and topical steroids, as well as immunosuppressive drugs such as topical cyclosporine. He also needed intrapalpebral depot-steroid injections and surgical excision of giant papillae with on two occasions in order to avoid deterioration of corneal affectation. Nevertheless, some treatments caused significant adverse effects and the patient worsened. Finally, Omalizumab was started with well tolerance and important improvement of clinical symptoms.

Conclusions:

Omalizumab is a humanized monoclonal antibody directed to free circulating IgE. It is approved for the treatment of severe asthma, but some studies had submitted its efficacy in vernal keratoconjunctivitis, and it is supposed to avoid side effects of some prolonged therapies. In conclusion, Omalizumab may be a good and safe option for the treatment of some cases of vernal keratoconjunctivitis but more controlled studies are needed.

Financial Disclosure:

None