Background: To evaluate the treatment with topical 0.05% cyclosporine A (CsA) in patients with subepithelial\r\ncorneal infiltrates (SEI).\r\nMethods: We reviewed 16 patients (22 eyes) before and after the treatment with 0.05% CsA eye drops. All patients\r\nhad been treated previously with topical corticosteroids without any improvement and also they had to stop the\r\nmedication secondary to intraocular pressure elevation. The objective data recorded included best-corrected visual\r\nacuity (BCVA), evaluation of corneal subepithelial infiltrate scores (CSIS), intraocular pressure (IOP) prior to treatment\r\nand the last follow-up visit.\r\nResults: Six males (37.5%) and 10 females (62.5%), mean age of 35.2 Ã?± 16.6 years, were included. The patientsââ?¬â?¢\r\naverage topical CsA use duration was 5.1 Ã?± 3.5 months (1 ââ?¬â?? 13 months). The average follow up time of the patients\r\nwas 9.2 Ã?± 4.7 months (4 ââ?¬â?? 22 months). One patient, although he didnââ?¬â?¢t have a 0 scale of SCIS, did not show up for\r\nfollow up examinations after six months. The mean BCVA (logarithm of the minimum angle of resolution) before\r\nand after the treatment were 0.15 Ã?± 0.15 and 0.07 Ã?± 0.07 respectively, CSIS 1.68 Ã?± 0.89 and 0.23 Ã?± 0.53 respectively,\r\nIOP 18.50 Ã?± 3.82 and 16.86 Ã?± 2.76 mmHg respectively. There were statistically significant improvements in BCVA\r\n(p = 0.002), reduction of CSIS (p = 0.002) and reduction of IOP (p < 0.001) prior to treatment and the last follow-up\r\nvisit. 18 eyes (81.9%) showed clinical improvement and 4 (18.1%) had decreased SEI which did not fully disappear\r\nduring the treatment period. The eyes which reached CSIS score 0 (18 eyes) were treated with CsA for\r\n1 ââ?¬â?? 13 months; while the eyes which had clinical improvement but had not CSIS score 0 (4 eyes) were decided to\r\ndiscontinue of CsA treatment in last follow-up visit. There were recurrences in 2 eyes 3 months after the treatment.\r\nPatients reported reduction in the severity of symptoms after the treatment. Most of the patients reported no\r\nforeign body sensation, glare, or other side effects with topical CsA treatment. Overall, patients noted an\r\nimprovement in vision and satisfaction with topical 0.05% CsA treatment.\r\nConclusions: Topical 0.05% CsA is a safe and effective alternative treatment in patients with SEI who do not\r\nrespond to other treatment modalities or have undesired side effects from topical steroids.
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