Lokales Cyclosporin A bei Nummuli nach Keratoconjunctivitis epidemica

Abstract

CSA was effective in eliminating or reducing nummuli in the majority of patients. More than one-half of the responding eyes had a complete cure and did not experience recurrences after stopping therapy. We therefore consider topical CSA to be a safe and effective alternative to topical steroids for treating nummular infiltrates after AK.

Comparison of clinical outcome with different treatment regimens in acute adenoviral keratoconjunctivitis

“…29 Cyclosporine was specifically explored for treating symptoms caused by subepithelial infiltrates. 12,13,19,20 One percent CsA administered 4 times a day for 21 days during acute infection produced earlier subjective improvement of local symptoms and a trend toward a lower incidence of corneal opacities. 20 In a second study, the majority of patients with longstanding established CSE were successfully treated with 2% CsA with reduction or elimination of SEIs and successful weaning off therapy.…”

“…20 In a second study, the majority of patients with longstanding established CSE were successfully treated with 2% CsA with reduction or elimination of SEIs and successful weaning off therapy. 19 Similarly, Levinger et al 13 reported improvement in vision and satisfaction with topical 1% CSA in 9 patients with subepithelial corneal infiltrates secondary to adenoviral keratoconjunctivitis. Romanowski et al found that treatment with both 2.0 and 0.5% CsA in the rabbit model significantly reduced the formation of SEIs.…”

“…Topical Cyclosporine A 2% was compounded in a carboxymethylcellulose vehicle (noncommercialized; prepared in the pharmacy of Baskent University Hospital, Ankara, Turkey). The 2% dosage was preferred because it was the highest dosage reported to be used topically for epidemic keratoconjunctivitis 19 without any systemic or local side effects, except for a case of childhood phlyctenular keratoconjunctivitis who developed a generalised skin rash under CsA 2% therapy. 22 The eye with a worse clinical picture was included in bilateral cases.…”

“…Although there are reports that show the efficacy of topical CsA (1 and 2%) in decreasing the incidence of corneal opacities and in the therapy of active subepithelial infiltrates during the chronic phase, [11][12][13]19,20 there are no studies reported to compare the safety and efficacy of topical Cyclosporine A with topical corticosteroids and palliative treatment in acute adenoviral keratoconjunctivitis. Therefore, we aimed to compare the clinical outcome with different treatment regimens including topical corticosteroids, Cyclosporin A and exclusively palliative therapy, in a large group of patients who admitted to two tertiary eye care centers.…”

Topical Treatment of Acute Adenoviral Keratoconjunctivitis With 0.2% Cidofovir and 1% Cyclosporine

“…These nummular opacities or infiltrates can impair visual function and can persist for months to years. 4 Histopathological investigation of focal biopsy samples revealed subepithelial infiltrates of lymphocytes, histiocytes, and fibroblasts accompanied by a disruption of the collagen fibers of the Bowman layer. 5,6 The pathogenesis of the nummular opacities most likely includes a persisting viral replication in subepithelial keratocytes, triggering an immunological host reaction.…”