*Cornea Department, Sadalla Amin Ghanem Eye Hospital, Joinville, Brazil; and †Univille University, Joinville, Brazil.
Cornea. 2014 Nov;33(11):1210-3. doi: 10.1097/ICO.0000000000000247.
To describe the use of topical 0.03% tacrolimus in patients with symptomatic corneal subepithelial infiltrates (SEIs) secondary to adenoviral keratoconjunctivitis (AK) that were resistant to tapering of corticosteroid eye drops.
This was a prospective, nonrandomized, noncomparative interventional case series that included consecutive patients treated with tacrolimus for resistant SEIs after AK. The patients had active SEIs and corrected distance visual acuity (CDVA) of 20/25 or worse when treatment was initiated. The recorded data included age, sex, CDVA, intraocular pressure, duration and intensity of symptoms, biomicroscopy findings, and duration of therapy. The treatment was considered successful if there was a reduction in SEIs, as well as CDVA stabilization or improvement. The treatment was considered unsuccessful if the patient could not tolerate tacrolimus or if there was an increase in SEIs.
Seven patients were included (10 eyes). The mean age was 36.7 ± 12.3 years. The mean duration of tacrolimus therapy was 8.8 ± 2.4 months, and the mean duration of follow-up was 13.6 ± 10.7 months. Treatment was successful in 8 eyes of 6 patients. One patient could not tolerate the medication. Statistically significant improvement in the CDVA was observed (from a mean of 0.29 to 0.07) (P = 0.001). No statistically significant changes in the intraocular pressure were observed (P = 0.574). SEI scores showed a significant reduction from 2.20 ± 0.92 to 0.25 ± 0.46 (P = 0.011). All patients who completed treatment had improvement in ocular symptoms.
Topical 0.03% tacrolimus seemed to be an effective corticosteroid-sparing agent for the treatment of SEIs after AK.
描述在因腺病毒角膜炎（AK）而对皮质类固醇眼药水逐渐减量仍有症状的角膜上皮下浸润（SEI）患者中，使用局部 0.03%他克莫司治疗的情况。
这是一项前瞻性、非随机、非对照的干预性病例系列研究，纳入了因 AK 而接受他克莫司治疗的 SEI 耐药患者。患者在开始治疗时即存在活动性 SEI 和矫正视力（CDVA）20/25 或更差。记录的数据包括年龄、性别、CDVA、眼压、症状持续时间和强度、生物显微镜检查结果以及治疗持续时间。如果 SEI 减少且 CDVA 稳定或改善，则认为治疗成功。如果患者不能耐受他克莫司或 SEI 增加，则认为治疗失败。
共纳入 7 例（10 只眼）患者。平均年龄为 36.7 ± 12.3 岁。他克莫司治疗的平均时间为 8.8 ± 2.4 个月，平均随访时间为 13.6 ± 10.7 个月。6 例患者的 8 只眼治疗成功。1 例患者不能耐受该药物。CDVA 显著改善（从平均 0.29 提高至 0.07）（P = 0.001）。眼压无显著变化（P = 0.574）。SEI 评分从 2.20 ± 0.92 显著降至 0.25 ± 0.46（P = 0.011）。所有完成治疗的患者均改善了眼部症状。
局部使用 0.03%他克莫司似乎是治疗 AK 后 SEI 的一种有效的皮质类固醇节约剂。
