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Application for tacrolimus ointment in treating refractory inflammatory ocular surface diseases

Title
 Application for tacrolimus ointment in treating refractory inflammatory ocular surface diseases 
Authors
 Young Ji Lee ; Sun Woong Kim ; Kyoung Yul Seo 
Issue Date
2013
Journal Title
 American Journal of Ophthalmology 
ISSN
 0002-9394 
Citation
 American Journal of Ophthalmology, Vol.155(5) : 804~813, 2013 
Abstract
PURPOSE: To evaluate the therapeutic effects of topical tacrolimus ointment on refractory inflammatory ocular surface diseases. DESIGN: Retrospective interventional consecutive case series. METHODS: In Severance Hospital, Seoul, South Korea, 0.02% tacrolimus ointment was topically applied 1 to 3 times per day, depending on disease severity, for up to 31 months in eyes of 12 consecutive patients with refractory inflammatory ocular surface diseases who had previously been treated with steroid therapy. Seven patients had chronic cicatrizing conjunctivitis (6 cases caused by Stevens-Johnson syndrome and 1 attributable to ocular cicatricial pemphigoid); 4 had scleritis (3 necrotizing scleritis, 1 recurrent nodular scleritis); and 1 patient had Mooren ulcer with corneal perforation. The therapeutic outcomes after tacrolimus treatment were evaluated according to the following criteria: change in clinical findings (eg, decrease of hyperemia, ocular pain, epithelial defect, and pseudomembrane), intraocular pressure (IOP), and need for steroid therapy. RESULTS: In all 3 groups, tacrolimus showed an immunosuppressive effect, especially on scleritis and Mooren ulcer. These effects included suppression of corneoscleral melting and reduction of hyperemia. In chronic cicatrizing conjunctivitis, simultaneous topical tacrolimus while tapering steroid therapy suppressed inflammatory relapse. The elevated IOP in steroid responders recovered to normal range after successful tapering of steroid. No adverse side effects were noted after 1.5 to 31 months of continuous tacrolimus treatment. CONCLUSION: The use of topical tacrolimus ointment is effective in controlling refractory inflammatory ocular surface disease, and can reduce the need for steroid use while reducing inflammation recurrence.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/87033
DOI
10.1016/j.ajo.2012.12.009
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Ophthalmology
Yonsei Authors
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Link
 http://www.sciencedirect.com/science/article/pii/S000293941200863X
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