Cetinkaya Altug, Akova Yonca Aydin, Dursun Dilek, Pelit Aysel
Department of Ophthalmology, Baskent University Faculty of Medicine, Ankara, Turkey.
Cornea. 2004 Mar;23(2):194-200. doi: 10.1097/00003226-200403000-00014.
To report our experience with 0.05%-2% topical cyclosporine in the treatment of 4 cases of severe, corticosteroid-resistant, vernal keratoconjunctivitis with shield ulcers.
Four patients with shield ulcers not responding to medical treatment with topical steroids, antihistamines, and mast-cell stabilizers were treated with 0.05%-2% topical cyclosporine. The frequency of application was 4 times daily in all cases, and the concentration was adjusted according to the clinical status starting with 2%.
Healing of ulcers with no epithelial defect occurred in 10 days with the 2% concentration in all cases. The patients experienced no side effects except for a burning sensation during administration. Recurrences occurred when the concentration was decreased to 0.05% in 3 cases. The recurrences were effectively treated with 1% concentration in all cases, and patients were stable with this concentration for at least 6 months.
Topical cyclosporine is an effective treatment alternative in the management of shield ulcers in patients with vernal keratoconjunctivitis. The 1% concentration seems to be the minimal effective concentration in such cases in our experience, but further controlled studies are needed to support our findings.
报告我们使用0.05%-2%的局部用环孢素治疗4例伴有盾形溃疡的重度、糖皮质激素抵抗性春季角结膜炎的经验。
4例对局部用类固醇、抗组胺药和肥大细胞稳定剂治疗无效的盾形溃疡患者接受了0.05%-2%的局部用环孢素治疗。所有病例的用药频率均为每日4次，并根据临床状况从2%开始调整浓度。
所有病例使用2%浓度时，溃疡在10天内愈合且无上皮缺损。患者除用药期间有烧灼感外无其他副作用。3例患者在浓度降至0.05%时出现复发。所有病例使用1%浓度均有效治疗了复发情况，且患者在该浓度下至少稳定6个月。
局部用环孢素是治疗春季角结膜炎患者盾形溃疡的一种有效替代疗法。根据我们的经验，1%浓度似乎是此类病例中的最低有效浓度，但需要进一步的对照研究来支持我们的发现。
