title: Efficacy of 1.25% and 1% topical cyclosporine in the treatment of severe vernal keratoconjunctivitis in childhood.
abstract: Cyclosporine eyedrops 2% have been used for treatment of corticosteroid-resistant vernal keratoconjunctivitis (VKC) cases. The purpose of our study was to verify the efficacy of 1.25% vs. 1% topical cyclosporine in improving severe form of VKC in childhood. Twenty children with severe VKC, were enrolled in a double-blind, placebo-controlled study and received cyclosporine 1.25% in one eye for 2 wk. Then an open trial was conducted during the next 3 months and 2 wk. Thirty-two more patients were recruited the next year into a new open trial and they received cyclosporine 1% for 4 months. Ocular subjective symptoms and objective signs were scored in all children at entry, 2 wk and 4 months. Skin prick tests and conjunctival scraping tests were also performed; serum immunological and biochemical markers were assessed. The mean score values for severity of subjective symptoms and objective signs were significantly decreased after 2 wk, and 4 months, compared with those at entry (p < 0.001), in both groups of children who received cyclosporine eyedrops 1.25% and 1%, respectively. Serum markers did not differ from the beginning to the end of treatment. Conjunctival eosinophils and cyclosporine serum levels were not detectable at the end of therapy, nor were endothelial corneal cells damaged. Our findings suggest that 1% cyclosporine concentration might be the minimal effective treatment regimen to control symptoms and local inflammation in severe forms of VKC.
authors.affiliation: Clinica Pediatrica I, Dipartimento di Biomedicina dell'Età Evolutiva, University of Bari, Bari, Italy. lspadavecchia@inwind.it
authors.forename: Laura
authors.initials: L
authors.lastname: Spadavecchia
authors.forename: Pietro
authors.initials: P
authors.lastname: Fanelli
authors.forename: Riccardina
authors.initials: R
authors.lastname: Tesse
authors.forename: Luigia
authors.initials: L
authors.lastname: Brunetti
authors.forename: Fabio
authors.initials: F
authors.lastname: Cardinale
authors.forename: Mario
authors.initials: M
authors.lastname: Bellizzi
authors.forename: Giovanna
authors.initials: G
authors.lastname: Rizzo
authors.forename: Ugo
authors.initials: U
authors.lastname: Procoli
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Bellizzi
authors.forename: Lucio
authors.initials: L
authors.lastname: Armenio
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000008:administration & dosage*; D004311:Double-Blind Method; D047150:Eosinophil Cationic Protein / Q000097:blood; D004804:Eosinophils / Q000276:immunology; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007637:Keratoconjunctivitis / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D008297:Male; D012882:Skin Tests
chemical_list: D007166:Immunosuppressive Agents; D007073:Immunoglobulin E; D016572:Cyclosporine; D047150:Eosinophil Cationic Protein; C479220:RNASE3 protein, human