title: Effect of 0.03% tacrolimus ointment on conjunctival cytology in patients with severe atopic blepharoconjunctivitis: a retrospective study.
abstract: OBJECTIVE
  To evaluate the efficacy and effect of tacrolimus ointment on conjunctival cytology in patients with atopic blepharoconjunctivitis or keratoconjunctivitis.
  
  
  METHODS
  Ten patients with severe atopic blepharoconjunctivitis treated with 0.03% tacrolimus ointment once daily as an intermittent treatment were analysed retrospectively. The main outcome measures were clinical response to topical tacrolimus, adverse events and changes in the inflammatory cells obtained from conjunctival brush samples.
  
  
  RESULTS
  Marked clinical responses in blepharitis and conjunctivitis symptoms were seen after a mean follow-up time of 6 weeks. Clinical scores decreased by 67% in blepharitis and 74% in conjunctivitis symptoms. No severe adverse events or signs of immunosuppression such as herpes simplex infections occurred. No significant changes occurred in visual acuity, refraction, anterior chamber, retina or intraocular pressure. Median decreases were 85% (p =0.01) in conjunctival eosinophils, 50% (p = 0.01) in neutrophils and 58% (p = 0.02) in lymphocytes.
  
  
  CONCLUSIONS
  Tacrolimus ointment is potentially a safe and effective treatment for atopic blepharoconjunctivitis. Regular treatment of the eyelids once daily may also lead to clinical and cytological improvement of the conjunctivitis.
authors.affiliation: Department of Dermatology, Hospital for Skin and Allergic Diseases, Helsinki University Central Hospital, Helsinki, Finland. hannele.kyllonen@fimnet.fi
authors.forename: Hannele M
authors.initials: HM
authors.lastname: Virtanen
authors.forename: Sakari
authors.initials: S
authors.lastname: Reitamo
authors.forename: Marjatta
authors.initials: M
authors.lastname: Kari
authors.forename: Osmo
authors.initials: O
authors.lastname: Kari
mesh_terms: D000328:Adult; D001762:Blepharitis / Q000188:drug therapy* / Q000473:pathology; D003228:Conjunctiva / Q000187:drug effects* / Q000473:pathology*; D003233:Conjunctivitis, Allergic / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D009824:Ointments; D012189:Retrospective Studies; D016559:Tacrolimus / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D009824:Ointments; D016559:Tacrolimus