Therapeutic Effect of 0.1% Tacrolimus Eye Drops in the Tarsal Form of Vernal Keratoconjunctivitis

Background. Vernal keratoconjunctivitis (VKC) is a rare ocular surface inflammatory disease that affects mainly boys in the first decade of life. Clinical observations show that it generally regresses spontaneously with the onset of puberty, but therapeutic measures must be taken before then to control the course of the disease. Purpose.To evaluate the role of the lacrimal mucous component in VKC patients and compare tear ferning test (TFT) modifications, MUC5AC levels in tears, and density of conjunctival goblet cells to clinical characteristics before and after treatment with cyclosporine A (CY) in eye drops. Methods. Forty-seven patients affected by VKC and 30 healthy subjects aged between 3 and 16 years of life were enrolled. All individuals were submitted to complete eye examination and skin prick test (SPT) for the most common allergens. Then, they were subjected to collection of the tears and to impression cytology to evaluate TFT, MUC5AC levels, and conjunctival goblet cell density, before and after treatment with CY in eye drops. Results. Comparing the VKC group vs. the control group at baseline, a significant alteration in the degree of the ferns was found, indicating a pathological condition of the lacrimal mucous layer. In addition, an increased number of goblet cells were observed in the patients. The concentration of lacrimal secretory mucins (MUC5AC) did not show significant differences between the 2 groups. Patients treated with CY have reported improvements of some signs and symptoms of disease activity, including TFT, and a tendency of conjunctival goblet cell density to normalise. Conclusions. The results obtained demonstrated for the first time a significant alteration of the lacrimal mucin component evaluated in the VKC group, and an improvement of the latter after CY therapy.

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Advanced Formulation Approaches for Ocular Drug Delivery: State-Of-The-Art and Recent Patents

Pharmaceutics ◽

10.3390/pharmaceutics11090460 ◽

2019 ◽

Vol 11 (9) ◽

pp. 460 ◽

Cited By ~ 25

Author(s):

Eliana B. Souto ◽

João Dias-Ferreira ◽

Ana López-Machado ◽

Miren Ettcheto ◽

Amanda Cano ◽

...

Keyword(s):

Drug Delivery ◽

Therapeutic Effect ◽

State Of The Art ◽

Circulatory System ◽

Drug Action ◽

New Drugs ◽

Eye Drops ◽

Target Segment ◽

Different Types ◽

A Current

The eye presents extensive perspectives and challenges for drug delivery, mainly because of the extraordinary capacity, intrinsic to this path, for drugs to permeate into the main circulatory system and also for the restrictions of the ocular barriers. Depending on the target segment of the eye, anterior or posterior, the specifications are different. The ocular route experienced in the last decades a lot of progresses related with the development of new drugs, improved formulations, specific-designed delivery and even new routes to administer a drug. Concomitantly, new categories of materials were developed and adapted to encapsulate drugs. With such advances, a multiplicity of parameters became possible to be optimized as the increase in bioavailability and decreased toxic effects of medicines. Also, the formulations were capable to easily adhere to specific tissues, increase the duration of the therapeutic effect and even target the delivery of the treatment. The ascending of new delivery systems for ocular targeting is a current focus, mainly because of the capacity to extend the normal time during which the drug exerts its therapeutic effect and, so, supplying the patients with a product which gives them fewer side effects, fewer number of applications and even more effective outcomes to their pathologies, surpassing the traditionally-used eye drops. Depending on the systems, some are capable of increasing the duration of the drug action as gels, emulsions, prodrugs, liposomes, and ocular inserts with hydrophilic properties, improving the absorption by the cornea. In parallel, other devices use as a strategy the capacity to sustain the release of the carried drugs by means of erodible and non-erodible matrices. This review discusses the different types of advanced formulations used for ocular delivery of therapeutics presenting the most recent patents according to the clinical applications.

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Nedocromil sodium eye drops are more effective than sodium cromoglycate eye drops for the long-term management of vernal keratoconjunctivitis

Clinical & Experimental Allergy ◽

10.1046/j.1365-2222.1999.00501.x ◽

1999 ◽

Vol 29 (4) ◽

pp. 529-536 ◽

Cited By ~ 34

Author(s):

VERIN ◽

DICKER ◽

MORTEMOUSQUE

Keyword(s):

Sodium Cromoglycate ◽

Nedocromil Sodium ◽

Vernal Keratoconjunctivitis ◽

Eye Drops ◽

Term Management

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Comparative Evaluation of Tacrolimus Versus Interferon Alpha-2b Eye Drops in the Treatment of Vernal Keratoconjunctivitis

Cornea ◽

10.1097/ico.0000000000001357 ◽

2018 ◽

Vol 37 (1) ◽

pp. e1

Author(s):

Parul Chawla Gupta ◽

Jagat Ram

Keyword(s):

Interferon Alpha ◽

Comparative Evaluation ◽

Vernal Keratoconjunctivitis ◽

Eye Drops ◽

Interferon Alpha 2B

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PP-018 Preparation of eye drops for vernal keratoconjunctivitis: the pharmacist added to a team acts as a fulcrum between doctor and patient

European Journal of Hospital Pharmacy ◽

10.1136/ejhpharm-2015-000639.298 ◽

2015 ◽

Vol 22 (Suppl 1) ◽

pp. A123.3-A124

Author(s):

V Borsi ◽

C Sgromo ◽

L Scala ◽

G Scialino ◽

A Calvani ◽

...

Keyword(s):

Vernal Keratoconjunctivitis ◽

Eye Drops

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COMPARATIVE EVALUATION OF TACROLIMUS 0.03% OINTMENT VS OLOPATADINE 0.2% EYE DROPS IN THE TREATMENT OF VERNAL KERATOCONJUNCTIVITIS

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i1.3251 ◽

2021 ◽

Vol 71 (1) ◽

pp. 34-39

Author(s):

Hassan Sajjad Rathore ◽

Shahzad Saeed ◽

Ahsan Mukhtar ◽

Umar Ijaz ◽

Asad Habib ◽

...

Keyword(s):

Subjective Symptom ◽

Military Hospital ◽

Vernal Keratoconjunctivitis ◽

Eye Drops ◽

Subjective Symptoms ◽

Cross Sectional ◽

Group A ◽

Objective Sign ◽

The Mean ◽

Group B

Objective: To compare the efficacy of tacrolimus 0.03% ointment to olopatadine 0.2% eye drops in the treatment of vernal keratoconjunctivitis. Study Design: Prospective cross-sectional study. Place and Duration of Study: Eye Department Combined Military Hospital Quetta, from Feb to Jul 2019. Methodology: A total of 69 patients with active vernal keratoconjunctivitis (VKC) were included in this study.Thirty six (52.17%) patients were randomized in tacrolimus group and 33 (47.83%) in olopatadine group B.Baseline values of the subjective symptom score (SSS) and the objective sign score (OSS) were noted. Patientswere reviewed on weeks 2, 4, 8 and 12 and the scores at each visit were summed. These scores were used forcomparison between groups. Results: At the start of the study, the mean subjective symptoms score and objective sign score of group A was 9.0 ± 2.04 and 3.93 ± 1.93 respectively, while that of group B was 8.88 ± 2.18 and 4.36 ± 1.90 respectively. At the end of 12-weeks, the mean subjective symptoms score and objective sign score of group A reduced to 0.11 ± 0.32 and 0.08 ± 0.28 respectively, while that of group B reduced to 1.70 ± 0.77 and 0.64 ± 0.55 respectively. Total improvement of scores (as a percentage of baselines) among tacrolimus group was 98.3% and olopatadine group was 83%. Conclusion: Although both 0.03% tacrolimus and 0.2% olopatadine were effective in improving the signs andsymptoms of VKC, 0.03% tacrolimus was significantly superior.

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Cyclosporine eye drops in vernal keratoconjunctivitis

Current Allergy and Asthma Reports ◽

10.1007/s11882-003-0095-5 ◽

2003 ◽

Vol 3 (4) ◽

pp. 343-343

Author(s):

Constance H. Katelaris

Keyword(s):

Vernal Keratoconjunctivitis ◽

Eye Drops

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Eyelash Length in Children with Vernal Keratoconjunctivitis: Effect of Treatment with Cyclosporine Eye Drops

International Journal of Immunopathology and Pharmacology ◽

10.1177/039463200702000317 ◽

2007 ◽

Vol 20 (3) ◽

pp. 595-599 ◽

Cited By ~ 4

Author(s):

N. Pucci ◽

C. Massai ◽

R. Bernardini ◽

R. Caputo ◽

F. Mori ◽

...

Keyword(s):

Rapid Change ◽

Ocular Inflammation ◽

Vernal Keratoconjunctivitis ◽

Eye Drops ◽

Rapid Improvement ◽

Humoral Factors ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

Group 1

The upper eyelashes in vernal keratoconjunctivitis (VKC) patients have been reported to be longer than in healthy age- and gender-matched subjects. Eyelash length positively correlated to the severity of the disease and negatively to the employment of cyclosporine eye drops, suggesting that specific humoral factors could be involved in both ocular inflammation and elongation of the eyelashes. The aim of the present study is to evaluate a possible relationship between eyelash length and the duration of topical cyclosporine treatment. The length of the upper eyelashes of 34 VKC patients never treated with topical cyclosporine (Cyc-NT) was matched with that of 58 VKC patients treated with cyclosporine (Cyc-T). The latter group was divided into three subgroups, depending on the duration of therapy: 1–6 months (group 1; 21 subjects), 7–12 months (group 2; 19 subjects), >12 months (group 3; 19 subjects). Cyc-NT patients' eyelashes were significantly longer than those of VKC patients treated for 1–6 months (group 1). No significant difference was found between Cyc-NT and Cyc-T patients in group 2 and group 3. The differences between Cyc-T patients and group 1 and 2, group 2 and 3, and group 1 and 3 were not statistically significant. The eyelash shortening observed seems directly related to the rapid improvement of ocular symptoms induced by the treatment. A receptor down-regulation by mediators of ocular inflammation may explain this data, although different cytokines, hormones or other humoral mediators could be expressed on the ocular surface at different stages of the disease, mainly in periods of rapid change of the clinical course.

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