title: Topical cyclosporine in the management of shield ulcers.
abstract: OBJECTIVE
  To report our experience with 0.05%-2% topical cyclosporine in the treatment of 4 cases of severe, corticosteroid-resistant, vernal keratoconjunctivitis with shield ulcers.
  
  
  METHODS
  Four patients with shield ulcers not responding to medical treatment with topical steroids, antihistamines, and mast-cell stabilizers were treated with 0.05%-2% topical cyclosporine. The frequency of application was 4 times daily in all cases, and the concentration was adjusted according to the clinical status starting with 2%.
  
  
  RESULTS
  Healing of ulcers with no epithelial defect occurred in 10 days with the 2% concentration in all cases. The patients experienced no side effects except for a burning sensation during administration. Recurrences occurred when the concentration was decreased to 0.05% in 3 cases. The recurrences were effectively treated with 1% concentration in all cases, and patients were stable with this concentration for at least 6 months.
  
  
  CONCLUSIONS
  Topical cyclosporine is an effective treatment alternative in the management of shield ulcers in patients with vernal keratoconjunctivitis. The 1% concentration seems to be the minimal effective concentration in such cases in our experience, but further controlled studies are needed to support our findings.
authors.affiliation: Department of Ophthalmology, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Altug
authors.initials: A
authors.lastname: Cetinkaya
authors.forename: Yonca Aydin
authors.initials: YA
authors.lastname: Akova
authors.forename: Dilek
authors.initials: D
authors.lastname: Dursun
authors.forename: Aysel
authors.initials: A
authors.lastname: Pelit
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D002648:Child; D003233:Conjunctivitis, Allergic / Q000188:drug therapy*; D016572:Cyclosporine / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D009883:Ophthalmic Solutions; D014456:Ulcer / Q000188:drug therapy*
chemical_list: D007166:Immunosuppressive Agents; D009883:Ophthalmic Solutions; D016572:Cyclosporine