title: Therapeutic Effect of 0.1% Topical Tacrolimus for Childhood Interstitial Keratitis Refractory to Cyclosporine.
abstract: OBJECTIVE
  To report our findings in a case of childhood refractory interstitial keratitis successfully treated with 0.1% topical tacrolimus.
  
  
  METHODS
  A 12-year-old boy presented with a 3-year history of interstitial keratitis. For the recurrent interstitial keratitis he had been treated with topical and systemic acyclovir, steroids, and topical cyclosporine for 3 years. Our examinations revealed severe stromal infiltrates and neovascularization. Treatment was changed from topical 0.5% cyclosporine to topical 0.1% tacrolimus combined with topical acyclovir and betamethasone.
  
  
  RESULTS
  After 2 weeks of treatment with topical tacrolimus, the degree of stromal infiltrates decreased. Although the improvements were slow, the stromal infiltrates resolved somewhat, and neovascularization and topical acyclovir and betamethasone were tapered and stopped in 18 months. Since then, the patient has not shown any recurrence for 9 months without medication.
  
  
  CONCLUSIONS
  Our findings indicate that topical tacrolimus should be considered for treating refractory interstitial keratitis in children.
authors.affiliation: Department of Ophthalmology, Ehime University Graduate School of Medicine.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Joko
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiraishi
authors.forename: Miki
authors.initials: M
authors.lastname: Ogata
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ohashi
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage; D000287:Administration, Topical; D001623:Betamethasone / Q000008:administration & dosage; D002648:Child; D016572:Cyclosporine / Q000008:administration & dosage; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents; D007634:Keratitis / Q000188:drug therapy*; D008297:Male; D012008:Recurrence; D016559:Tacrolimus / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D001623:Betamethasone; D016559:Tacrolimus; D000212:Acyclovir