Benaim D, Tétart F, Bauvin O, Delcampe A, Joly P, Muraine M, Gueudry J
Service d'ophtalmologie, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
Service de dermatologie, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
J Fr Ophtalmol. 2019 May;42(5):435-440. doi: 10.1016/j.jfo.2018.07.018. Epub 2019 Mar 29.
Atopic keratoconjunctivitis is associated with eyelid eczema. It may require the use of local corticosteroids which if prolonged can be a source of ocular complications. Tacrolimus is an immunosuppressant used in cutaneous application in atopic dermatitis. The aim of this study was to measure the efficacy and tolerance of tacrolimus 0.1% ointment in palpebral application in atopic keratoconjunctivitis.
This retrospective, single-center study was conducted between June 2014 and February 2017. Patients with atopic keratoconjunctivitis not controlled by first-line medical treatments were included. The primary endpoint was the evolution of functional signs as assessed by the NEI-VFQ25 and OSDI quality of life scores. Secondary endpoints were visual acuity and local corticosteroid use.
Among the 18 patients included, the mean age was 37.9±16.8 years. The first follow-up visit was on average 68.3±55.3 days after initiation of treatment. The NEI-VFQ25 score was significantly improved for seven of its sub-scores (P<0.05) and the mean OSDI decreased significantly from 52.3±26.2 to 22.0±27.0 (P<0.001) showing a decrease in eye discomfort. A significant reduction was observed in the number of patients using local corticosteroids. There was no significant change in visual acuity.
Tacrolimus ointment 0.1% in palpebral application appears to be an effective treatment for the management of atopic keratoconjunctivitis.
特应性角结膜炎与眼睑湿疹相关。可能需要使用局部皮质类固醇激素，但如果使用时间过长，可能会引发眼部并发症。他克莫司是一种免疫抑制剂，用于特应性皮炎的皮肤应用。本研究的目的是评估0.1%他克莫司软膏睑部应用治疗特应性角结膜炎的疗效和耐受性。
本回顾性单中心研究于2014年6月至2017年2月进行。纳入一线药物治疗无法控制的特应性角结膜炎患者。主要终点是通过NEI-VFQ25和OSDI生活质量评分评估的功能体征变化。次要终点是视力和局部皮质类固醇激素的使用情况。
纳入的18例患者中，平均年龄为37.9±16.8岁。首次随访平均在治疗开始后68.3±55.3天。NEI-VFQ25评分的7个亚评分显著改善（P<0.05），平均OSDI评分从52.3±26.2显著降至22.0±27.0（P<0.001），表明眼部不适减轻。使用局部皮质类固醇激素的患者数量显著减少。视力无显著变化。
0.1%他克莫司软膏睑部应用似乎是治疗特应性角结膜炎的有效方法。
