Therapeutic effects of tacrolimus ointment for refractory ocular surface inflammatory diseases
Therapeutic effects of tacrolimus ointment for refractory ocular surface inflammatory diseases
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DOI：
10.1016/j.ophtha.2007.07.025
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发表时间：
2008-06-01
期刊：
影响因子：
13.7
通讯作者：
Inoue, Yoshitsugu
中科院分区：
文献类型：
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作者：
Miyazaki, Dai;Tominaga, Takeshi;Inoue, Yoshitsugu
目的：探讨局部他克莫司软膏对难治性眼表炎性疾病的治疗效果。设计：回顾性干预连续病例series.Participants：10例连续严重眼表炎性疾病患者被怀疑是类固醇反应（眼内压升高[IOP]）或难治性标准类固醇治疗进行了研究。1例周边溃疡性角膜炎伴角膜穿孔，1例蚕蚀性角膜溃疡，2例巩膜周炎，5例特应性角膜结膜炎，1例春季角膜结膜炎。方法：通过常规眼科检查确定0.02%外用他克莫司软膏治疗后的临床表现和治疗反应。解决眼表疾病（例如，减少充血、溃疡、乳头大小）和IOP。还评估了使用类固醇的必要性。结果：在所有病例中，均获得了显着至中度的改善，包括抑制发炎角膜的融化反应、缓解硬化性角膜周炎以及减少严重特应性角膜结膜炎的巨大乳头和角膜上皮缺陷。成功停止类固醇治疗后，类固醇反应者升高的IOP降低。连续治疗2 ~ 26个月，未见不良副作用。结论：外用他克莫司软膏可有效治疗难治性眼表炎性疾病，应考虑作为高剂量、类固醇补充或手术干预的替代方法。
Purpose: To investigate the therapeutic effects of topical tacrolimus ointment on refractory ocular surface inflammatory diseases.Design: Retrospective interventional consecutive case series.Participants: Ten consecutive patients with severe ocular surface inflammatory diseases who were suspected to be steroid responders (elevation of intraocular pressure [IOP]) or were refractory to standard steroid therapy were studied. One patient had peripheral ulcerative keratitis with impending corneal perforation, 1 had a Mooren's ulcer, 2 had scleroperikeratitis, 5 had atopic keratoconjunctivitis, and 1 had vernal keratoconjunctivitis.Methods: The clinical findings and therapeutic responses after treatment with 0.02% topical tacrolimus ointment were determined by conventional ophthalmological examinations.Main Outcome Measures: Resolution of the ocular surface diseases (e.g., decrease of hyperemia, ulceration, size of papillae) and IOP. The necessity to use steroids was also assessed.Results: In all cases, marked to moderate improvement was obtained, including suppression of the melting reaction of the inflamed cornea, remission of scleroperikeratitis, and reduction of a giant papilla and corneal epithelial defect in severe atopic keratoconjunctivitis. The elevated IOP was reduced in steroid responders after successful cessation of steroid therapy. No adverse side effect was noted for 2 to 26 months of continuous treatment.Conclusions: Topical tacrolimus ointment is effective in treating refractory ocular surface inflammatory diseases and should be considered as an alternative to higher doses, steroid supplementation, or surgical intervention.