Systemic cyclosporine A in severe atopic keratoconjunctivitis.

OBJECTIVE: Atopic keratoconjunctivitis (AKC) is a potentially blinding disease. It is usually associated with atopic dermatitis that has been managed successfully with systemic cyclosporine A (CSA) in some severe forms of the disease. In this study, the authors evaluated systemic CSA therapy in patients with severe AKC.

DESIGN: Cohort Retrospective study.

PARTICIPANTS: Four patients aged 31 to 64 with severe AKC and atopic dermatitis refractory to or dependent on steroid therapy.

INTERVENTION: The patients received oral CSA.

MAIN OUTCOME MEASURES: Ocular inflammation, skin condition, CSA treatment methods (dosage, duration), CSA-related side effects.

RESULTS: Daily dosage of oral CSA was 3 to 5 mg/kg and mean duration of treatment was 37 months (range, 22-48 months). Ocular inflammation was controlled totally in three patients. One patient responded only partially to treatment. Side effects included renal toxicity in one patient. Reduction of CSA dosage resulted in normalization of serum creatinine level.

CONCLUSIONS: This report suggests that systemic CSA represents an interesting alternative therapy in severe AKC.