topical tacrolimus 0,03% for treatment of refractory allergic conjunctivitis diane marinho, andréia...

$: Topical Tacrolimus 0,03% for Treatment of Refractory Allergic Conjunctivitis Diane Marinho, Andréia Ferreira Laranjeira, Sérgio Kwitko, Samuel Rymer Hospital$
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.



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


Figures 1. Patient 3 30 and 120 days pos treatment


Figures 2: Patient 2 pre treatment and 15 days pos treatment

Figures 3: Patient 2 pre treatment and 30 days pos treatment


• Conclusion:Conclusion:

The tacrolimus 0,03% eyedrops appears to be an effective and safe alternative for allergic conjunctivitis refractory to traditional treatment or corticoid dependent.

topical tacrolimus 0,03% for treatment of refractory allergic conjunctivitis diane marinho, andréia...

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