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Órgano Oficial del Colegio Mexicano de Alergia, Asma e Inmunología Pediátrica y de la Asociación Latinoamericana de Pediatría

2012, Number 1

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Alerg Asma Inmunol Pediatr 2012; 21 (1)

Refractory vernal keratoconjunctivitis, is tacrolimus a therapeutic option?: Prospective study

Ramírez RH, Reina Z, Espinoza Y, Soto ML, Hernández A, Cardona R

Language: Spanish
References: 25
Page: 5-12
PDF size: 98.56 Kb.


ABSTRACT

Introduction: Vernal keratoconjunctivitis is a chronic inflammatory conjunctival process. With the evolution of disease, some complications such as corneal ulcers may occur. Chronic forms have led to blindness in as many as 5% of patients. Many patients’ symptoms do not improve with conventional treatment and continue until complications occur. Objective: To describe the clinical evolution of patients diagnosed with vernal keratoconjunctivitis who consulted the Clinical Allergy Service, IPS Universitaria of the Universidad de Antioquia receiving a daily treatment with 0.03% tacrolimus in the lower palpebral edge. Material and methods: This observational study describes a prospective cohort of 26 patients with vernal keratoconjunctivitis who received a daily application of topical 0.03% tacrolimus on the edge of the eye lid. The treatment was monitored over 9 months. Results: 26 cases were collected: 6 (23.08%) women and 20 (76.92%) men. Fifteen (57.69%) patients reported a family history of atopy and 92.31% had a personal history of other non-ocular allergy: 24 (92.31%) rhinitis, 15 (57.69%) asthma, and 11 (42.31%) atopic dermatitis. A sensitization to dust mites was found in 23 children. Fifty percent of patients showed an improvement during the first month of treatment. On the end of follow up, 100% of patients showed statistically significant clinical improvement, having no symptoms, after 5.8 months. During the treatment there were only a few adverse effects: burning sensation and two cases of acute bacterial conjunctivitis. Conclusions: Topical application of 0.03% tacrolimus ointment on the lower eye lid, could be an effective and safe alternative for patients with refractory vernal keratoconjunctivitis. This could be especially important for those who have received conventional treatment without success.


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