Cyclosporine effects on clinical findings and impression cytology specimens in severe vernal keratoconjunctivitis

Purpose: To investigate the possible effects of topical cyclosporine eye dr ops 2% (CsA) on conjunctival immune cells obtained by impression cytology t echnique and to determine the clinical relevance of this effect if present. Methods: Ten consecutive patients with severe, resistant, and active verna l keratoconjunctivitis (VKC) were included in this study. All of them were treated with 2% of topical CsA drops. Symptom and clinical scores and conju nctival impression cytology specimens were obtained both before and followi ng treatment. Impression cytology specimens were stained with anti-CD8+, CD 4+, CD45RA+, and CD23+ antibodies and the percentages of positive cells wer e counted. The results were compared and correlation analyses were performe d between clinical and laboratory data. Results: Significant reductions wer e observed with respect to the percentages of CD4+ and CD23+ cells in the c onjunctival impression cytology specimens and clinical and symptom scores f ollowing treatment with topical CsA, while no change occurred in the percen tages of CD8+ and CD45RA+ cells. The percentages of CD4+ and CD23+ cells sh owed good correlations with symptom and clinical scores. Conclusion: Topica l CsA treatment is a very effective alternative in severe VKC cases in clin ical ground and clinical efficacy of topical CsA treatment in severe, resis tant VKC cases can be (at least partly) related to reduction of the CD23+ a nd CD4+ cell populations on the conjunctival surface. Copyright (C) 2001 S. KargerAG, Basel.