Department of Ophthalmology (H.Y., H.F.), Tsurumi University School of Dental Medicine, Kanagawa, Japan ; Department of Ophthalmology (H.Y.), Keio University School of Medicine, Tokyo, Japan ; and Ophthalmology and Visual Science (D.M.), Faculty of Medicine Tottori University, Tottori, Japan.
Eye Contact Lens. 2021 Apr 1;47(4):185-190. doi: 10.1097/ICL.0000000000000696.
To report experience with 0.1% tacrolimus eye drops in the treatment of noninfectious, non-necrotizing anterior scleritis.
This prospective, single-arm study included nine patients (4 men and 5 women; mean age=59.4 years, SD=10.5) with anterior scleritis. All patients were first treated with steroids for 1 month and then switched to tacrolimus eye drops alone. We defined baseline as the initiation of tacrolimus eye drops. Hyperemia and pain were scored before each treatment, at 1 and 2 weeks, and at 1 month after initiation of each treatment using 5 grades (0=none; 1+=mild; 2+=moderate; 3+=severe; 4+=extremely severe). Intraocular pressure (IOP) was also measured during treatment with each drug. Safety was assessed based on the severity and the incidence of adverse events.
The scores of hyperemia and pain had significantly decreased from baseline by 1 week after initiating tacrolimus eye drops (both P<0.05). No significant reduction was observed with steroid treatment throughout the 1-month period in both scores. Tacrolimus eye drops elicited statistically significant differences in mean IOP over the course of treatment (P=0.02). No additional medications were required to provide relief in any of the patients receiving tacrolimus treatment. No patient demonstrated infectious adverse events after initiation of tacrolimus treatment.
Topical tacrolimus may effectively and immediately reduce clinical signs and symptoms of noninfectious, non-necrotizing anterior scleritis in cases unresponsive to a course of topical steroid.
报告 0.1%他克莫司滴眼液治疗非感染性、非坏死性前部巩膜炎的经验。
本前瞻性、单臂研究纳入了 9 例（4 男 5 女；平均年龄=59.4 岁，标准差=10.5）前部巩膜炎患者。所有患者均首先接受皮质类固醇治疗 1 个月，然后单独转换为他克莫司滴眼液。我们将基线定义为开始使用他克莫司滴眼液的时间。在每次治疗前、治疗后 1 周和 2 周以及开始每次治疗后 1 个月，使用 5 级评分（0=无；1+=轻度；2+=中度；3+=重度；4+=极重度）对充血和疼痛进行评分。在每次用药期间还测量眼内压（IOP）。安全性基于不良事件的严重程度和发生率进行评估。
从开始使用他克莫司滴眼液后 1 周起，充血和疼痛评分均较基线显著降低（均 P<0.05）。在整个 1 个月期间，皮质类固醇治疗对这两个评分均无显著降低。他克莫司滴眼液在治疗过程中对平均 IOP 产生了统计学上的显著差异（P=0.02）。在接受他克莫司治疗的患者中，没有任何患者需要额外的药物来缓解症状。在开始使用他克莫司治疗后，没有患者出现感染性不良事件。
对于对局部皮质类固醇治疗无反应的非感染性、非坏死性前部巩膜炎病例，局部使用他克莫司可能会有效且立即减轻临床体征和症状。
