Rivkin Angeline C, Bernhisel Ashlie A
University of Illinois at Chicago College of Medicine, 1853 W Polk St, Chicago, IL, USA, 60612.
Mayo Clinic Department of Ophthalmology, 200 1st St SW, Rochester, MN, USA, 55902.
Am J Ophthalmol Case Rep. 2025 Jan 17;37:102256. doi: 10.1016/j.ajoc.2025.102256. eCollection 2025 Mar.
Conjunctival lymphoid hyperplasia is a benign condition that typically presents with irritation, conjunctival injection, and eyelid edema. Topical corticosteroid drops are often the first-line treatment when not excised, but long-term use may cause intraocular pressure spikes or cataract formation. Steroid-sparing agents could be considered to manage patients who require long-term treatment. Here we discuss the potential benefit of topical tacrolimus use for the management of these patients.
We present two cases of conjunctival lymphoid hyperplasia, one in a 74-year-old man and one in a 41-year-old woman. Both showed a positive response to topical steroid treatment, but due to intraocular pressure elevations, needed to be trialed on steroid-sparing medications. Topical tacrolimus (Protopic) at 0.03 % concentration was applied to the inferior fornix. Patients were monitored for improvement on exam and for subjective improvement of their symptoms. Topical tacrolimus produced moderate to complete resolution of the lesions in these patients and resulted in symptomatic improvement.
Tacrolimus is an immunomodulatory medication. The ointment form is approved for use in atopic dermatitis (eczema). Although it is an off-label use, it has been used for other ocular conditions with variable success and tolerability, but we did not find any prior reports of its use in conjunctival benign lymphoid hyperplasia.
结膜淋巴样增生是一种良性疾病，通常表现为眼刺激感、结膜充血和眼睑水肿。在不进行切除的情况下，局部使用皮质类固醇滴眼液通常是一线治疗方法，但长期使用可能会导致眼压升高或白内障形成。对于需要长期治疗的患者，可以考虑使用类固醇节省剂。在此，我们讨论局部使用他克莫司治疗这些患者的潜在益处。
我们报告两例结膜淋巴样增生病例，一例为74岁男性，另一例为41岁女性。两例患者对局部类固醇治疗均显示出阳性反应，但由于眼压升高，需要试用类固醇节省药物。将浓度为0.03%的局部他克莫司（普特彼）应用于下穹窿。对患者进行检查以观察病情改善情况，并观察其症状的主观改善情况。局部使用他克莫司使这些患者的病变得到中度至完全消退，并使症状得到改善。
他克莫司是一种免疫调节药物。其软膏剂型已被批准用于特应性皮炎（湿疹）。尽管这是一种超说明书用药，但它已被用于其他眼部疾病，疗效和耐受性各不相同，但我们未发现其用于结膜良性淋巴样增生的任何先前报道。
