title: Effect of Topical Tacrolimus in the Treatment of Thygeson's Superficial Punctate Keratitis.
abstract: OBJECTIVE
  To evaluate topical tacrolimus ointment for treating Thygeson's superficial punctate keratitis (Thygeson SPK).
  
  
  METHODS
  Retrospective interventional case series.
  
  
  METHODS
  setting: Institutional practice.
  
  
  METHODS
  The medical records of 14 patients (9 women; age range, 9-65 years) with Thygeson SPK were reviewed retrospectively. Diagnosis was based on the history and clinical examination.
  
  
  METHODS
  Patients were treated with tacrolimus 0.03% eye ointment instilled into the lower fornix twice daily for the first 2 weeks, followed by nocturnal application. The clinical signs and symptoms were assessed after 1 month of treatment. The drug was tapered with disease improvement.
  
  
  METHODS
  Treatment efficacy and side effects.
  
  
  RESULTS
  All patients had bilateral disease (average duration, 6 years). All patients, except 2 who used the medication irregularly, had improved visual acuity (VA), symptoms, and signs as long as the medication was applied. Before treatment 28.57% of patients had VA between 20/30 and 20/50, with improvement after treatment to 20/25 or 20/20. Attempts to withdraw the medication resulted in recurrent disease, and, therefore, treatment was not curative during the study period. No significant local medication side effects were reported.
  
  
  CONCLUSIONS
  Tacrolimus eye ointment 0.03% was effective for controlling Thygeson SPK for a long period with good patient tolerance and no noticeable local or systemic side effects. During the average 6-year follow-up, treatment was not curative. Randomized studies are difficult to conduct because of the disease rarity.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Maria Carolina
authors.initials: MC
authors.lastname: Marquezan
authors.affiliation: Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Heloisa
authors.initials: H
authors.lastname: Nascimento
authors.affiliation: Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Luis Antonio
authors.initials: LA
authors.lastname: Vieira
authors.affiliation: Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Myrna
authors.initials: M
authors.lastname: Serapião
authors.affiliation: Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Ramon Coral
authors.initials: RC
authors.lastname: Ghanem
authors.affiliation: Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Rubens
authors.initials: R
authors.lastname: Belfort
authors.affiliation: Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, São Paulo, Brazil. Electronic address: dfreitas@uol.com.br.
authors.forename: Denise
authors.initials: D
authors.lastname: Freitas
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007634:Keratitis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009824:Ointments; D009883:Ophthalmic Solutions; D012189:Retrospective Studies; D016559:Tacrolimus / Q000627:therapeutic use*; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D009824:Ointments; D009883:Ophthalmic Solutions; D016559:Tacrolimus