title: Topical Cyclosporine A 1% for the Treatment of Chronic Follicular Conjunctivitis.
abstract: OBJECTIVE
  To evaluate the use of topical cyclosporine A (CSA) 1% in the treatment of chronic follicular conjunctivitis (CFC).
  
  
  METHODS
  Retrospective chart review from 2001 to 2012 identified 12 patients (22 eyes) with CFC (mean ± standard deviation [SD] age, 50.2 ± 15.4 years; 75% female; 92% white) treated with CSA. Main outcome measures included inflammation grade, visual acuity, concurrent corticosteroid (CS) therapy, effect on CS taper, and adverse effects.
  
  
  RESULTS
  Mean ± SD follow-up time was 11.7 ± 9.7 months. Mean ± SD time from diagnosis to CSA treatment initiation was 2.4 ± 3.2 months. Mean ± SD duration of CSA treatment was 5.8 ± 2.8 months. Four patients (33%) complained of irritation (n = 2), redness (n = 1), itching (n = 1), and burning (n = 1) but none discontinued treatment. Concurrent CSs were tapered off in all patients after a mean ± SD of 5.0 ± 2.5 weeks. Mean ± SD initial vision was 0.078 ± 0.093 logMAR, whereas vision at final examination was 0.056 ± 0.081 logMAR (P = 0.02). Mean ± SD initial inflammation grade of 1.9 ± 1.0 was significantly reduced to final grade of 0.7 ± 0.9 (P = 0.0002). Mean ± SD time to initial inflammation control in 9 patients (75%) was 33.2 ± 24.5 days. Two patients (17%) switched to oral CSA because of lack of inflammation control.
  
  
  CONCLUSIONS
  Topical CSA 1% is an effective and well-tolerated therapy that decreased chronic inflammation and tapered topical CS in patients with CFC. The use of CSA in such patients warrants further investigation.
authors.affiliation: Department of Pittsburgh (A.M.K.), University of Pittsburgh Medical Center, Pittsburgh, PA; Institute of Ophthalmology and Visual Science (N.V.N., A.R., J.S.K., C.F., E.S.K., D.S.C.), Rutgers University, Newark, NJ; and Metropolitan Eye Research and Surgery Institute (D.S.C.), Palisades Park, NJ.
authors.forename: Anton M
authors.initials: AM
authors.lastname: Kolomeyer
authors.forename: Natasha V
authors.initials: NV
authors.lastname: Nayak
authors.forename: Ashwinee
authors.initials: A
authors.lastname: Ragam
authors.forename: Jason S
authors.initials: JS
authors.lastname: Kim
authors.forename: Christina
authors.initials: C
authors.lastname: Fang
authors.forename: Elliott S
authors.initials: ES
authors.lastname: Kim
authors.forename: David S
authors.initials: DS
authors.lastname: Chu
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D016572:Cyclosporine / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007637:Keratoconjunctivitis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000627:therapeutic use*; D012189:Retrospective Studies; D014792:Visual Acuity
chemical_list: D007166:Immunosuppressive Agents; D009883:Ophthalmic Solutions; D016572:Cyclosporine