Department of Ophthalmology, Donald K. Johnson Eye Center, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada.
Cornea. 2010 Jun;29(6):638-40. doi: 10.1097/ICO.0b013e3181c33034.
To evaluate the treatment with topical 1% cyclosporine A (CsA) in patients with subepithelial corneal infiltrates (SEIs).
We retrospectively reviewed the records of 9 patients (12 eyes) before and after the treatment with CsA 1% eyedrops twice daily. All patients had been treated with topical corticosteroids previously without improvement or had to stop the medication secondary to intraocular pressure elevation. The objective data recorded included best-corrected Snellen visual acuity, intraocular pressure, number of medications in use, and evaluation of severity of SEIs (improved, stable, or worse). For their subjective evaluation, patients were asked to complete a questionnaire based on the last follow-up visit.
Five males (56%) and 4 females (44%), mean age of 47 +/- 13 years, were included. Mean follow-up on CsA was 13 +/- 7 months. The mean best-corrected Snellen visual acuity (logarithm of the minimum angle of resolution) before and after treatment was 0.42 +/- 0.40 and 21 +/- 0.28, respectively, with no statistically significant improvement. There was statistically significant reduction in the number of medications before and after treatment from 1.88 +/- 1.05 to 1.22 +/- 0.44, respectively (P = 0.049). Six patients (66%) showed clinical improvement, and 3 (34%) were stable during the treatment period. Patients reported statistically significant reduction in the severity of symptoms before and after the treatment. Most of the patients reported no foreign body sensation, glare, or other side effects with topical CsA treatment. Overall, patients noted an improvement in vision and satisfaction with CsA treatment.
Topical CsA 1% is a safe and effective alternative treatment in patients with SEIs who do not respond to other treatment modalities or have unwanted side effects from topical steroids.
评估上皮下角膜浸润（SEI）患者局部应用 1％环孢素 A（CsA）的治疗效果。
我们回顾性分析了 9 例（12 只眼）患者在接受 CsA 1％滴眼剂每日 2 次治疗前后的记录。所有患者先前均接受过局部皮质类固醇治疗，但无改善，或因眼压升高而不得不停药。记录的客观数据包括最佳矫正视力、眼压、用药种类以及 SEI 严重程度的评估（改善、稳定或恶化）。对于他们的主观评估，患者根据最后一次随访完成了一份问卷。
5 名男性（56％）和 4 名女性（44％），平均年龄为 47±13 岁。CsA 的平均随访时间为 13±7 个月。治疗前后平均最佳矫正视力（最小角分辨率对数）分别为 0.42±0.40 和 21±0.28，无统计学显著改善。治疗前后用药种类分别从 1.88±1.05 降至 1.22±0.44，有统计学显著减少（P=0.049）。6 例（66％）患者出现临床改善，3 例（34％）患者在治疗期间稳定。患者报告治疗前后症状严重程度均有统计学显著减轻。大多数患者报告局部 CsA 治疗后无异物感、眩光或其他副作用。总体而言，患者注意到视力改善和对 CsA 治疗的满意度提高。
对于对其他治疗方法无反应或局部皮质类固醇有不良反应的 SEI 患者，局部应用 1％CsA 是一种安全有效的替代治疗方法。
