Cyclosporine effects on clinical findings and impression cytology specimens in severe vernal keratoconjunctivitis.
OBJECTIVE
To investigate the possible effects of topical cyclosporine eye drops 2% (CsA) on conjunctival immune cells obtained by impression cytology technique and to determine the clinical relevance of this effect if present.


METHODS
Ten consecutive patients with severe, resistant, and active vernal keratoconjunctivitis (VKC) were included in this study. All of them were treated with 2% of topical CsA drops. Symptom and clinical scores and conjunctival impression cytology specimens were obtained both before and following treatment. Impression cytology specimens were stained with anti-CD8+, CD4+, CD45RA+, and CD23+ antibodies and the percentages of positive cells were counted. The results were compared and correlation analyses were performed between clinical and laboratory data.


RESULTS
Significant reductions were observed with respect to the percentages of CD4+ and CD23+ cells in the conjunctival impression cytology specimens and clinical and symptom scores following treatment with topical CsA, while no change occurred in the percentages of CD8+ and CD45RA+ cells. The percentages of CD4+ and CD23+ cells showed good correlations with symptom and clinical scores.


CONCLUSIONS
Topical CsA treatment is a very effective alternative in severe VKC cases in clinical ground and clinical efficacy of topical CsA treatment in severe, resistant VKC cases can be (at least partly) related to reduction of the CD23+ and CD4+ cell populations on the conjunctival surface.
Avunduk
A M
AM
Karadeniz Technical University, School of Medicine, Department of Ophthalmology, Trabzon, Turkey. avni_murat_avunduk@hotmail.com
Avunduk
M C
MC
Erdöl
H
H
Kapicioglu
Z
Z
Akyol
N
N
D000293:Adolescent; D000328:Adult; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D002648:Child; D003228:Conjunctiva / Q000187:drug effects* / Q000276:immunology / Q000473:pathology; D003233:Conjunctivitis, Allergic / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017493:Leukocyte Common Antigens / Q000276:immunology; D008297:Male; D009883:Ophthalmic Solutions; D017455:Receptors, IgE / Q000276:immunology
D007166:Immunosuppressive Agents; D009883:Ophthalmic Solutions; D017455:Receptors, IgE; D016572:Cyclosporine; D017493:Leukocyte Common Antigens