Efficacy and safety of topical tacrolimus 0.03% ointment in thygeson superficial punctate keratitis.

Article Information

Title: Efficacy and safety of topical tacrolimus 0.03% ointment in thygeson superficial punctate keratitis.

Authors: Adnan Ahmad, Shams Ul Haq, Jamal Hussain, Javed Rasool, Mubashir Rehman

Journal: The Professional Medical Journal (TPMJ)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2022-07-01	2023-06-30
Y	2021-07-01	2022-06-30

Publisher: Independent Medical College, Faisalabad- Pakistan

Country: Pakistan

Year: 2023

Volume: 30

Issue: 1

Language: English

DOI: 10.29309/TPMJ/2023.30.01.7193

Keywords: OintmentDermatologicalTopical TacrolimusThygeson Superficial Punctate Keratitis

Abstract

Objective: To assess the effectiveness of topical tacrolimus (TCL) 0.03% dermatological ointment in the treatment of patients with Thygeson superficial punctate keratitis. Study Design: Retrospective Review. Setting: Eye OPD of Qazi Hussain Ahmad Medical Complex, Nowshera. Period: Jan 2019 to Jan 2021. Material &amp; Methods: Twelve patients with Thygeson superficial punctate keratitis (TSPK) were included retrospectively by reviewing their medical records. Eight patients were unresponsive to topical steroids and/or lubricants. Diagnosis was made based on the history and clinical findings. All patients were treated with topical tacrolimus 0.03% dermatological ointment twice a day. We took the following subjective features for assessment i.e. watering of eyes and light sensitivity, while for objective features reduction in the no. of epithelial keratitis, healing of keratitis, surface leveling of the lesion and reduced corneal staining with fluorescein. Results: Out of total 12 patients, 4 were male and 8 females with a mean age of 21 ± 9.42 years. All were having bilateral involvement. Duration of therapy ranged from 02 to 40 weeks (mean 08 weeks). All patients improved symptomatically with resolution of watering of eyes and light sensitivity, while in ocular signs we noted improvement in corneal lesions. The efficacy of therapy was observed 3 days, post application among all patients. No, side effects reported in any of our patients treated with topical TCL dermatological ointment. Conclusion: The safety and efficacy of topical tacrolimus 0.03% dermatological ointment has been observed in patients with Thygeson superficial punctate keratitis who were refractory to conventional therapy.

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Research Objective

To assess the effectiveness of topical tacrolimus (TCL) 0.03% dermatological ointment in the treatment of patients with Thygeson superficial punctate keratitis.

Methodology

Retrospective review of medical records of 12 patients with Thygeson superficial punctate keratitis (TSPK) treated at the Eye OPD of Qazi Hussain Ahmad Medical Complex, Nowshera, from January 2019 to January 2021. Eight patients were unresponsive to conventional therapy (topical steroids and/or lubricants). All patients were treated with topical tacrolimus 0.03% dermatological ointment twice daily. Assessment included subjective features (watering of eyes, light sensitivity) and objective features (reduction in epithelial keratitis, healing of keratitis, surface leveling of lesions, reduced corneal staining).

Methodology Flowchart

                        graph TD;
    A["Identify TSPK Patients Jan 2019 - Jan 2021"] --> B["Review Medical Records"];
    B --> C["Select 12 Patients"8 Refractory""];
    C --> D["Administer Topical Tacrolimus 0.03% Ointment BID"];
    D --> E["Assess Subjective & Objective Features"];
    E --> F["Analyze Results"];
    F --> G["Conclude Efficacy and Safety"];

Discussion

The cause of TSPK is unclear, with theories including viral infections and immune deregulation. Topical corticosteroids are the standard treatment but can have long-term side effects and are not effective in all cases. Tacrolimus, a calcineurin inhibitor, may be more effective due to its potent inhibitory effect on Langerhans cells, which are implicated in TSPK pathogenesis. The study suggests tacrolimus is a safe and effective alternative for refractory TSPK.

Key Findings

All 12 patients (4 male, 8 female, mean age 21 ± 9.42 years) with bilateral involvement showed symptomatic improvement with resolution of watering and light sensitivity. Objective signs also improved, with reduction in corneal lesions. Efficacy was observed within 3 days of application. No side effects were reported.

Conclusion

Topical tacrolimus 0.03% dermatological ointment is safe and efficacious in treating Thygeson superficial punctate keratitis in patients refractory to conventional therapy.

Fact Check

1. Study Period: The study was conducted from January 2019 to January 2021. (Confirmed in text)
2. Number of Patients: Twelve patients with TSPK were included in the study. (Confirmed in text)
3. Tacrolimus Concentration: Topical tacrolimus 0.03% ointment was used for treatment. (Confirmed in text)

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