Objective: Atopic keratoconjunctivitis (AKC) is a potentially blinding
disease. It is usually associated with atopic dermatitis that has bee
n managed successfully with systemic cyclosporine A (CSA) in some seve
re forms of the disease. in this study, the authors evaluated systemic
CSA therapy in patients with severe AKC. Design: Cohort. Retrospectiv
e study, Participants: Four patients aged 31 to 64 with severe AKC and
atopic dermatitis refractory to or dependent on steroid therapy, Inte
rvention: The patients received oral CSA, Main Outcome Measures: Ocula
r inflammation, skin condition, CSA treatment methods (dosage, duratio
n), CSA-related side effects. Results: Daily dosage of oral CSA was 3
to 5 mg/kg and mean duration of treatment was 37 months (range, 22-48
months). Ocular inflammation was controlled totally in three patients.
One patient responded only partially to treatment. Side effects inclu
ded renal toxicity in one patient, Reduction of CSA dosage resulted in
normalization of serum creatinine level. Conclusions: This report sug
gests that systemic CSA represents an interesting alternative therapy
in severe AKC.