Combined Topical Corticosteroid and Topical Cyclosporine-A 0.05% for Management of COVID-19 Keratoconjunctivitis: A pilot study.

Hagras, Sherein Mahmoud; Nassief, Mona Abdelhamid; Abdelhameed, Ameera Gamal; Alduwailah, Omar Khaled

doi:10.21608/ejomos.2021.96897.1033

Combined Topical Corticosteroid and Topical Cyclosporine-A 0.05% for Management of COVID-19 Keratoconjunctivitis: A pilot study.

Document Type : Original Articles

Authors

¹ ophthalmology; faculty of medicine; Mansoura university; Mansoura; Egypt

² ophthalmology department, Tanta University, Faculty of medicine

³ ophthalmology department, Mansoura University, Faculty of Medicine, Mansoura, Egypt

⁴ ophthalmology department, Farwanyiah Hospital, Kuwait.

10.21608/ejomos.2021.96897.1033

Abstract

Purpose
To evaluate the effectiveness and safety of combined use of topical corticosteroids and topical Cyclosporine-A 0.05% in the treatment of COVID-19 acute Keratoconjunctivitis.
Study design: A pilot study.
Methods
Twelve patients (13 eyes) with COVID-19 acute Keratoconjunctivitis received topical 1% prednisolone acetate 4 times daily, 0.05% cyclosporine-A 4 times daily together with non-preserved artificial tears. Symptoms and signs were recorded before and after treatment.
Results
Seven females and 5 males with a mean age of 42.5 ± 10.89 years (range 23-61 years) were included. Baseline examination of all patients revealed variable degrees of eyelid swelling, conjunctival hyperemia and follicular conjunctivitis. Keratitis had a characteristic pattern of small (˂1mm), gray-white marginal subepithelial infiltrates raising the overlying epithelium without associated epithelial defect. They were separated from the limbus by about 1 mm of clear space and in some cases; they extended for 12 o’clock hours circumlimbal. With treatment, patients reported rapid improvement of symptoms with a mean duration of 3.25 ± 1.6 days (range 1-6 days). At the 7th day of treatment, all signs disappeared in all patients, except for patient number 5, who had persistent mild conjunctival hyperemia and SEI which resolved completely by the 10th day of treatment. No recurrence of SEI was noted after 3 weeks. No ocular side effects of prednisolone acetate or cyclosporine-A were noted in any patient.
Conclusion
Combined topical 1% prednisolone acetate and 0.05% cyclosporine-A appears to be effective, and safe in the treatment of COVID-19 Keratoconjunctivitis.

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