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Topical ciclosporin in the treatment of ocular surface disorders

¹ The Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
² Department of Ophthalmology, Pamukkale University School of Medicine, Denizli, Turkey

Correspondence to:
Correspondence to:
Esen Karamursel Akpek
MD, Ocular Surface and Dry Eye Clinic, The Wilmer Eye Institute, 600 North Wolfe Street, Maumenee Building 317, Baltimore, MD 21287–9238, USA; esakpek{at}jhmi.edu

Mounting evidence suggests that inflammation is the key factor in the pathogenesis of various ocular surface diseases, with a complex interplay of genetic, environmental, and psychosocial factors. Management of these conditions is often challenging. Topical corticosteroids, with their associated side effects, are the mainstay of current treatments for patients with vision threatening disease. Ciclosporin A is an immunomodulator that specifically inhibits T lymphocyte proliferation. Recently, a topical ciclosporin preparation was approved by the US Food and Drug Administration and became available for use in ophthalmology. Given the increasing use of ciclosporin eye drops, the goal of this article is to provide the reader with an overview of the well established uses of ciclosporin and to help refine the questions that should be addressed by future investigations.

Abbreviations: CsA, ciclosporin A; IL-2, interleukin-2; PUK, peripheral ulcerative keratitis

Keywords: ocular surface disease; ciclosporin A; dry eye syndrome; vernal keratoconjunctivitis; atopic keratoconjunctivitis; keratitis; Thygeson’s superficial punctate keratitis; ligneous conjunctivitis; lichen planus; superior limbic keratoconjunctivitis