Yazu Hiroyuki, Fukagawa Kazumi, Shimizu Eisuke, Sato Yasunori, Fujishima Hiroshi
Department of Ophthalmology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi Tsurumi-ku, Yokohama-shi, Kanagawa, 230-8501, Japan.
Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Allergy Asthma Clin Immunol. 2021 Feb 1;17(1):11. doi: 10.1186/s13223-021-00513-w.
Because atopic dermatitis does not heal completely, associated severe atopic keratoconjunctivitis (AKC) and vernal keratoconjunctivitis (VKC) often require long-term treatment. This study aims to evaluate the long-term outcomes of using 0.1% tacrolimus eye drops to treat these severe allergic conjunctival diseases.
Two-hundred-and-seventy eyes of 135 patients diagnosed with AKC or VKC from April 2004 to April 2014 were screened retrospectively. Patient demographics and objective signs were extracted from the electronic medical records. The severity of 10 objective signs, related to the palpebral and bulbar conjunctiva, limbus, and cornea, and intraocular pressure (IOP) were observed at baseline, at 2 weeks, 1, 2, 3, 6, and 12 months after starting treatment, and every 1 year thereafter (average use period: 8.4 ± 2.9 years). Safety was evaluated based on the incidence and severity of adverse events.
12 patients (AKC; 7 cases, VKC; 5 cases) who were treated with 0.1% tacrolimus eye drops were enrolled in this study. The total score of clinical signs significantly decreased after 2 weeks and remained effective thereafter. Tacrolimus eye drops elicited a statistically significant difference in the mean total clinical scores and IOP over the course of treatment (P < 0.001). Elevated IOP was observed in 2 cases and corneal infection in 1 case; these effects were completely controlled with medication.
Topical tacrolimus may provide effective and long-term improvement in clinical signs of severe AKC and VKC cases that refractory to standard conventional treatment.
University Hospital Medical Information Network (UMIN) 000034460.
由于特应性皮炎无法完全治愈，相关的重度特应性角结膜炎（AKC）和春季角结膜炎（VKC）通常需要长期治疗。本研究旨在评估使用0.1%他克莫司滴眼液治疗这些重度过敏性结膜疾病的长期疗效。
回顾性筛查2004年4月至2014年4月期间诊断为AKC或VKC的135例患者的270只眼。从电子病历中提取患者人口统计学信息和客观体征。在基线、开始治疗后2周、1、2、3、6和12个月以及此后每年观察与睑结膜、球结膜、角膜缘和角膜相关的10项客观体征的严重程度以及眼压（IOP）（平均使用期：8.4±2.9年）。基于不良事件的发生率和严重程度评估安全性。
本研究纳入了12例接受0.1%他克莫司滴眼液治疗的患者（AKC；7例，VKC；5例）。2周后临床体征总分显著下降，此后一直有效。他克莫司滴眼液在治疗过程中使平均临床体征总分和眼压产生了统计学上的显著差异（P<0.001）。观察到2例眼压升高和1例角膜感染；这些影响通过药物得到了完全控制。
局部使用他克莫司可能为标准常规治疗无效的重度AKC和VKC病例的临床体征提供有效且长期的改善。
大学医院医学信息网络（UMIN）编号000034460。
