Topical cyclosporin A for nummular infiltrates after adenoviral keratoconjunctivitis. A pilot study

Background. Recurrences are common after discontinuing topical steroids aga inst nummular infiltrates following adenoviral keratoconjunctivitis (AK). T o avoid the potentially serious side effects of resumed steroid treatment a t increased doses we tested topical 2% cyclosporin A (CSA). Patients. We applied four drops of CSA daily to 70 eyes (48 patients) with persistent nummular infiltrates after AK. Treatment began 18.5 months (3-72 ) after the acute phase of AK. Dose reduction depended on resolution of the nummuli in the individual patients. Results. Of the 70 eyes 40 responded positively to therapy, 16 showed no ch ange, therapy was stopped in 4 because of ocular discomfort (burning), and in 10 eyes followup is still less than 3 months. Conclusions. CSA was effective in eliminating or reducing nummuli in the ma jority of patients. More than one-half of the responding eyes had a complet e cure and did not experience recurrences after stopping therapy. We theref ore consider topical CSA to be a safe and effective alternative to topical steroids for treating nummular infiltrates after AK.