Topical cyclosporine a 1% for the treatment of chronic follicular conjunctivitis

Objective:To evaluate the use of topical cyclosporine A (CSA) 1% in the treatment of chronic follicular conjunctivitis (CFC).Methods:Retrospective chart review from 2001 to 2012 identified 12 patients (22 eyes) with CFC (mean±standard deviation [SD] age, 50.2±15.4 years; 75% female; 92% white) treated with CSA. Main outcome measures included inflammation grade, visual acuity, concurrent corticosteroid (CS) therapy, effect on CS taper, and adverse effects.Results:Mean±SD follow-up time was 11.7±9.7 months. Mean±SD time from diagnosis to CSA treatment initiation was 2.4±3.2 months. Mean±SD duration of CSA treatment was 5.8±2.8 months. Four patients (33%) complained of irritation (n2), redness (n1), itching (n1), and burning (n1) but none discontinued treatment. Concurrent CSs were tapered off in all patients after a mean±SD of 5.0±2.5 weeks. Mean±SD initial vision was 0.078±0.093 logMAR, whereas vision at final examination was 0.056±0.081 logMAR (P0.02). Mean±SD initial inflammation grade of 1.9±1.0 was significantly reduced to final grade of 0.7±0.9 (P0.0002). Mean±SD time to initial inflammation control in 9 patients (75%) was 33.2±24.5 days. Two patients (17%) switched to oral CSA because of lack of inflammation control.Conclusions:Topical CSA 1% is an effective and well-tolerated therapy that decreased chronic inflammation and tapered topical CS in patients with CFC. The use of CSA in such patients warrants further investigation.