Title | Topical ciclosporin in the treatment of vernal keratoconjunctivitis in Rwanda, Central Africa: a randomised, double-masked, controlled clinical trial |
Purpose | To compare the short-term efficacy and safety of topical ciclosporin A (CsA) 2% with dexamethasone 0.1% in the treatment of predominantly limbal VKC in Rwanda. |
Methods | Consecutive patients with VKC were randomised in a prospective, double-masked, clinical trial to receive either topical CsA 2% dissolved in olive oil vehicle or dexamethasone 0.1% drops for 4 weeks. Both groups then received sodium chromoglycate 2% drops for maintenance therapy for a further 4 weeks. The primary outcome was the reduction in composite score for VKC-related symptoms and signs at 4 weeks. Secondary outcomes included side effects, comfort rating of the trial drops during 4 weeks test medication, and relapse rate thereafter. |
Results | The 366 participants recruited had the limbal (91.5%) or mixed form of VKC. At the end of the 4 week treatment period the composite score had significantly (p<0.001) reduced from baseline without a significant difference between CsA and dexamethasone (p= 0.20).There were no severe adverse reactions but CsA drops caused more stinging than the oil placebo and dexamethasone (p<0.001). The relapse rate following cessation of the trial treatments was similar (p= 0.84) in both groups. |
Conclusion | There is no significant difference between the efficacy of topical CsA 2% and dexamethasone 0.1% for the management of acute VKC in Central Africa, but tolerance needs to be improved. |
Last name | DE SMEDT |
Initials | SK |
Department | Ophthalmology Department, Ghent University Hospital |
City | Gent |
Last name | NKURIKIYE |
Initials | J |
Department | Ophthalmology Department, King Faisal Hospital |
City | Kigali, Rwanda |
Last name | FONTEYNE |
Initials | Y |
Department | Kabgayi Hospital |
City | Muhanga, Rwanda |
Last name | TUFT |
Initials | S |
Department | Moorfields Eye Hospital NHS Foundation Trust |
City | London, UK |
Last name | DE BACQUER |
Initials | D |
Department | Public Health Department, Ghent University Hospital |
City | Gent |
Last name | GILBERT |
Initials | C |
Department | International Centre for Eye Health |
City | London, UK |
Last name | KESTELYN |
Initials | P |
Department | Ophthalmology Department, Ghent University Hospital |
City | Gent |