Low-strength tacrolimus shows promise for pediatric vernal keratoconjunctivitis

Investigators report the use of a topical tacrolimus monotherapy for vernal keratoconjunctivitis (VKC).

Study design

This was a prospective nonrandomized observational study of 45 newly diagnosed children who were seen at Aravind Eye Hospital in South India. Patients aged 5 to 15 years were treated with tacrolimus 0.03% and followed for 8 months. Disease severity was graded on a 4-point scale based on signs and symptoms.

Outcomes

By 8 months, 89% of the participants achieved significant clinical improvement, exhibiting dramatic improvements in average composite sign (9.6 vs. 1.2; P<0.001) and symptom (6.8 vs. 0.7; P<0.001) scores from baseline. Within the first month of treatment, only 4 patients were started on steroids, and they were considered treatment failures. No adverse events were observed.

Limitations

This is an off-label use of tacrolimus 0.03% ophthalmic ointment. Although 60 patients were initially enrolled, only 45 were available for the final analysis.

Clinical significance

These findings suggest low-strength topical tacrolimus can have an important role in the management of pediatric VKC.