Modern Approach to Managing Vernal Keratoconjunctivitis

Kumar, Sunil; Gupta, Nitin; Vivian, Anthony J.

doi:10.1007/s11882-010-0101-7

Cited by 12 publications

(6 citation statements)

References 37 publications

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“…Tear substitutes aid in stabilization of the tear film, act as an eyewash, and dilute the concentration of the allergens and mediators in tears. Eye drops containing herbal extracts, such as chamomile-containing preparations, should be avoided because they may cross-react with sensitizing allergens [11] (Table 1). …”

Section: Management Of Vkcmentioning

confidence: 99%

Management of Vernal Keratoconjunctivitis

Leonardi

2013

Ophthalmol Ther

130

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Vernal keratoconjunctivitis (VKC) is a relatively rare, chronic form of ocular allergy that can potentially cause severe visual complications. Affecting mainly children and young adults, it is an IgE- and T cell-mediated disease, leading to a chronic inflammation in which eosinophil, lymphocyte and structural cell activation are involved. Treatment of VKC requires a multiple approach that includes conservative measures and pharmacologic treatment. Patients and parents should be made aware of the long duration of disease, its chronic evolution and possible complications. Treatment should be based on the duration and frequency of symptoms and the severity of corneal involvement. Mast cell stabilizers and antihistamines have been proven to be effective for the treatment of mild to moderate forms of VKC. In the most severe cases, topical steroids can be used as rescue medication to reduce conjunctival and corneal inflammation. Immunomodulators that have been investigated for VKC treatment include topical ocular preparations of cyclosporine A and tacrolimus. Topical cyclosporine A has been proven to be effective in the long-term treatment of VKC, significantly improving signs and symptoms without significant side effects.

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Section: Management Of Vkcmentioning

confidence: 99%

Management of Vernal Keratoconjunctivitis

Leonardi

2013

Ophthalmol Ther

130

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“…Pucci N et al, Kumar S et al, Labcharoenwongs P et al respectively) where many of the patients had discontinued the drugs resulting in recurrence of disease [6][7][8] . In a longer open trial by Spadavecchia L et al in 2006, utilizing a lower concentration of cyclosporine (1.25% and 1%) for 4 months, a higher degree of benefit in subjective and objective scores were reported which is in concordance with the present study [9] . )…”

Section: Discussionmentioning

confidence: 99%

A comparative study of efficacy, tolerability and safety of 0.03% tacrolimus eye ointment and 0.05% cyclosporin eye drops in the treatment of vernal keratoconjunctivitis

Padmini¹,

Tasneem²,

Nayak³

et al. 2021

Int. J. Med. Ophthalmol.

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Background: Vernal keratoconjunctivitis (VKC) is a common, chronic, bilateral, recurrent, allergic, inflammatory disease of the ocular surface primarily affecting young males in dry, hot climates such as India. Objectives: To compare the efficacy, tolerability and safety of 0.03% tacrolimus eye ointment and 0.05% cyclosporin eye drops in the treatment of vernal keratoconjunctivitis. Methods: A prospective study of 72 patients conducted from December 2017 to February 2021. After having established a diagnosis of VKC and fulfilling inclusion and exclusion criteria, participants were divided into two groups. Group 1 was put on cyclosporin eye drops and group 2 was put on tacrolimus eye ointment. Detailed history and evaluation for symptoms, signs, visual acuity and IOP was done on first visit and subsequently after 6 weeks, 12 weeks and 24 weeks. Results: 72 patients were diagnosed to have VKC, of whom males were 86% and females 13.9%, all belonging to the age group 5 to 14 years and were divided into two groups. Both the groups showed significant reduction in the symptoms and signs with no significant difference in efficacy between the groups and they maintained normal IOP and visual acuity at 6 weeks, 12 weeks and 24 weeks. Conclusion: Both the immunomodulators were equally successful in resolving the signs and symptoms of VKC, tolerable with no significant adverse effects and proved to be a safer alternative to steroids as they caused no elevation of intraocular pressure or any complications associated with the use of steroids.

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“…Results of immunohistochemical studies inform us that VKC is an allergic inflammatory disease involving mast cells, eosinophils, lymphocytes, basophils, dendritic cells, and macrophages that infiltrate the conjunctival epithelium and stroma [6,7]. Pharmacological treatment options for VKC include antihistamines, mast-cell stabilizers, dual-acting agents, corticosteroids, and immunomodulators such as Cyclosporine A and Tacrolimus [8]. As far as we know, topical corticosteroids are very effective in the treatment of VKC.…”

Section: Introductionmentioning

confidence: 97%

Topical Use of Olopatadine and Cyclosporine a in Treatment of Vernal Keratoconjunctivitis

Knatova¹,

Kantarcı²,

Akata³

et al. 2016

Ann Clin Anal Med

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with Cyclosporine A ophthalmic solution (0.05%) in treating the signs and symptoms of VKC. Material and Method: Twenty-five patients with VKC were included in a prospective study. One eye of each patient was treated with Olopatadine while the other eye was treated with Cyclosporine A. Subjective symptoms of the patients such as itching, tearing, foreign body sensation, and mucus discharge were recorded and scored. The objective signs, such as the presence of giant papillae on the tarsal conjunctiva, bulbar conjunctival hyperemia, keratitis, limbal hypertrophy, corneal vascularization, and conjunctival cicatrization, were scored. Results: There was no significant difference between the Olopatadine group and the Cyclosporine A group regarding subjective symptoms at the 3rd, 6th, 12th, and 18th month. There was a significant improvement in the subjective symptoms of both groups. No significant difference was seen between the groups with regard to objective signs. A significant improvement was observed in the Cyclosporine group in the late period of the study. Discussion: In long-term therapy of VKC, similar effects were seen regarding improvement in the subjective symptoms during the use of topical Olopatadine and Cyclosporine A. In terms of improvement regarding the objective signs, Cyclosporine A was seen to be more effective in the late period.

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Modern Approach to Managing Vernal Keratoconjunctivitis

Cited by 12 publications

References 37 publications

Management of Vernal Keratoconjunctivitis

Management of Vernal Keratoconjunctivitis

A comparative study of efficacy, tolerability and safety of 0.03% tacrolimus eye ointment and 0.05% cyclosporin eye drops in the treatment of vernal keratoconjunctivitis

Topical Use of Olopatadine and Cyclosporine a in Treatment of Vernal Keratoconjunctivitis

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