Karaca Emine Esra, Çelik Gökhan, İdacı Koç Şule, Evren Kemer Özlem
Department of Ophthalmology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara 06800, Turkey.
Department of Ophthalmology, Tarsus State Hospital, Mersin 33460, Turkey.
Biomedicines. 2025 Apr 8;13(4):895. doi: 10.3390/biomedicines13040895.
Epidemic keratoconjunctivitis (EKC) is a common viral ocular infection that can lead to persistent subepithelial infiltrates (SEIs), resulting in significant visual impairment and patient discomfort, necessitating effective treatment strategies beyond corticosteroid monotherapy. This study aims to evaluate the efficacy of topical tacrolimus (0.1%) ointment alone versus its combination with prednisolone (1%) drops to provide optimal therapeutic strategies for SEIs secondary to EKC. This retrospective observational study evaluates 102 eyes of ninety-five individuals. The patients were divided into two groups based on the treatment approach. The first group received tacrolimus ointment alone (n = 34), whereas the second group received a combination of prednisolone drops and tacrolimus ointment (n = 68). Best-corrected visual acuity (BCVA), the corneal subepithelial infiltrate score (CSIS), the subjective symptom score (SSS), and the Fantes corneal haze grading score (FCHGS) were evaluated before treatment and at 1, 3, 6, 9, 12, and 18 months post-treatment. Both groups showed significant improvements in the BCVA, CSIS, SSS, and FCHGS values, with no significant difference between the groups at 18 months ( > 0.05). The combination therapy resulted in a significantly faster treatment response than tacrolimus alone ( < 0.05) in terms of CSIS, SSS, and FCHGS values. An increase in intraocular pressure (IOP) was observed in four patients in the combination treatment group after three months. Topical tacrolimus, both alone and in combination with topical prednisolone, was effective in treating subepithelial infiltrates secondary to EKC. Combination therapy may be applied early for faster recovery; however, close monitoring of IOP is necessary in individuals using topical prednisolone.
流行性角结膜炎（EKC）是一种常见的病毒性眼部感染，可导致持续性上皮下浸润（SEIs），从而造成严重的视力损害和患者不适，因此需要超越皮质类固醇单一疗法的有效治疗策略。本研究旨在评估局部用他克莫司（0.1%）软膏单独使用及其与泼尼松龙（1%）滴眼液联合使用的疗效，以为EKC继发的SEIs提供最佳治疗策略。这项回顾性观察研究评估了95名个体的102只眼睛。根据治疗方法将患者分为两组。第一组仅接受他克莫司软膏（n = 34），而第二组接受泼尼松龙滴眼液和他克莫司软膏联合治疗（n = 68）。在治疗前以及治疗后1、3、6、9、12和18个月评估最佳矫正视力（BCVA）、角膜上皮下浸润评分（CSIS）、主观症状评分（SSS）和范特斯角膜混浊分级评分（FCHGS）。两组的BCVA、CSIS、SSS和FCHGS值均有显著改善，在18个月时两组之间无显著差异（> 0.05）。就CSIS、SSS和FCHGS值而言，联合治疗的治疗反应明显比单独使用他克莫司更快（< 0.05）。联合治疗组有4名患者在3个月后出现眼压（IOP）升高。局部用他克莫司单独使用以及与局部用泼尼松龙联合使用，对于治疗EKC继发的上皮下浸润均有效。联合治疗可早期应用以更快恢复；然而，使用局部用泼尼松龙的个体需要密切监测眼压。
