Topical Tacrolimus 0,03% for Treatment of Refractory Allergic Conjunctivitis Diane Marinho, Andréia...
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Transcript of Topical Tacrolimus 0,03% for Treatment of Refractory Allergic Conjunctivitis Diane Marinho, Andréia...
Topical Tacrolimus 0,03% for Treatment of Refractory Allergic
Conjunctivitis
Diane Marinho, Andréia Ferreira Laranjeira ,
Sérgio Kwitko, Samuel Rymer
Hospital de Clínicas de Porto Alegre
Federal University of Rio Grande do Sul - Porto Alegre - Brazil
The authors have no financial interest in the subject matter of this poster
Treatment of severe allergic conjuntivitis is a big challenge, since eyedrops containing antihistamines or sodium chromoglycate and its derivates are often insufficient. The addition of corticoids is often required, but the risk of glaucoma, cataract or atrophy of the skin limits the use of corticoids to short courses.
• PurposePurposeTo evaluate the efficacy of topical tacrolimus
0,03% in the treatment of allergic conjunctivitis refractory to conventional treatment or dependent of corticosteroids.
Topical Tacrolimus for Allergic Conjunctivitis Topical Tacrolimus for Allergic Conjunctivitis
1. Virtanen H et al. Effect of 0,03% tacrolimus ointment on conjunctival cytology in patients with severe atopic blepharoconjunctivitis: a retrospective study. Acta Ophthalmol. Scand 2006;84: 693-695.
2. Tacrolimus Ointment 0,03% in the Eye for Treatment of Giant Papillary Conjunctivitis Cornea 2008; 27: 228-229.
Methods Methods
• 13 patients with ocular allergy 9 vernal conjunctivitis 3 chronic atopic conjunctivitis 1 allergic dermatoconjunctivitis
• Topical tacrolimus 0,03% twice daily• Clear of topical antihistamines and corticoids for
at least one week• Follow-up between 6-16 months• Ophthalmological examination in days 15th, 30ty and
monthly after
Topical Tacrolimus for Allergic Topical Tacrolimus for Allergic Conjunctivitis Conjunctivitis
• ResultsResultsPatients referred total symptoms relief after a mean
follow-up time of 2 weeks. Two patients referred burning sensation and interrupted the eyedrops in the first two weeks of treatment. No other medications were necessary for ocular allergy control. One patient showed ponderal gain of 12 pounds and school improvement since tacrolimus introduction. No one restarted with corticoids or antihistamines eyedrops during treatment with tacrolimus. After two weeks of the begining, seven patients related reduced burning sensation with topical tacrolimus. No adverse event due to local imunossupression, in visual acuity or in refraction was observed.
Topical Tacrolimus for Allergic Topical Tacrolimus for Allergic Conjunctivitis Conjunctivitis
Topical Tacrolimus for Allergic Topical Tacrolimus for Allergic Conjunctivitis Conjunctivitis
Table 1: Patients caracteristics and follow-up
Patients Age(Yrs) Gender Conjunctivitis Previous history Follow-up (months) Incident or Adverse event
1 6 M VERNAL 1,2,4,5,6 16 Burning sensation 1st week 2 8 M VERNAL 1,2,4,5 16 - 3 16 M VERNAL 1,3,5,7 16 Tacrolimus sttoped for 2 months: new crisis 4 24 M ALLERGIC 1,2,3,4,5 14 Burning sensation for 2 weeks 5 22 F ATOPIC 1,4,5,6 14 - 6 18 M VERNAL 1,2,3,4,5 - Sttoped in 2 weeks (burning) 7 11 F VERNAL 1,2,4,5 11 Burning sensation 1st week 8 8 M VERNAL 3,4,5,6 8 Burning sensation for 3 weeks 9 18 M ATOPIC 1,2,3,5 - Sttoped in the first week (burning) 10 19 M ATOPIC 1,2,3,4,5,6,7 10 - 11 16 M VERNAL 1,3,4,5,6 9 - 12 9 M VERNAL 2,4,5 9 Burning sensation 1st week 13 7 M VERNAL 1,3,4,5 - Burning sensation for 2 weeks
1- Rinitis 2- Asthma 3- Atopic dermatitis 4- Corticoid use >3 times/year 5- Cronic use of antihistamines or mast cells stabilizers eyedrops 6- Corneal ulcer 7- Cataract Yrs= years M=male F=female
Topical Tacrolimus for Allergic Conjunctivitis Topical Tacrolimus for Allergic Conjunctivitis
Figures 1. Patient 3 30 and 120 days pos treatment
Topical Tacrolimus for Allergic Conjunctivitis Topical Tacrolimus for Allergic Conjunctivitis
Figures 2: Patient 2 pre treatment and 15 days pos treatment
Figures 3: Patient 2 pre treatment and 30 days pos treatment