ciclosporina tópica2

7/25/2019 ciclosporina tpica2

1/23

Ciclosporina topica 0,05%Ciclosporina topica 0,05%

(Restasis, Allergan)(Restasis, Allergan)


2/23

Ojo secoOjo seco

Ojo seco cronico: infamacin mediada porOjo seco cronico: infamacin mediada porLinocitos es cla!e"Linocitos es cla!e"

erapia anti#infamatoria (corticoides)erapia anti#infamatoria (corticoides)mejoran signos $ sintomas, pero tienenmejoran signos $ sintomas, pero tienenRA&sRA&s Arc' oc sp Otamol *000+5:5-#.Arc' oc sp Otamol *000+5:5-#.

CsA dismin/$e infamacin de gland/las $CsA dismin/$e infamacin de gland/las $s/percie oc/lar, a/mentando prod/ccins/percie oc/lar, a/mentando prod/ccin

lacrimal"lacrimal" Restasis es 1ien tolerado (-% esco2or, 5Restasis es 1ien tolerado (-% esco2or, 5

de *34 a1andonaron por RA) $ ni!elesde *34 a1andonaron por RA) $ ni!elesplasmaticos son indetecta1les"plasmaticos son indetecta1les" Op'talmolog$Op'talmolog$*000+-0:.4-#3*000+-0:.4-#3


3/23

Ojo secoOjo seco

ncl/sin:ncl/sin: Ojo seco moderado a se!ero (67, 89,Ojo seco moderado a se!ero (67, 89,

sintomas, sc'irmer con anestesia 5)sintomas, sc'irmer con anestesia 5) Resp/esta ins/ciente a l/1ricacinResp/esta ins/ciente a l/1ricacin

;cl/sin:;cl/sin:

Ojo seco m/$ se!ero (sc'imer 4)Ojo seco m/$ se!ero (sc'imer 4) neccin acti!aneccin acti!a Lentes de contactoLentes de contacto


4/23

Ojo secoOjo seco


5/23

Ojo secoOjo seco

Compati1le con lagrimas articialesCompati1le con lagrimas articiales @o mejor pacientes con tapones@o mejor pacientes con tapones

p/nctales o con antiinfamatoriosp/nctales o con antiinfamatoriossistemicossistemicos

6/en c/mplimiento (3%) $ satisaccin6/en c/mplimiento (3%) $ satisaccin("5=-0)("5=-0) Clin 'er" *00. @o!+*(--):-?#5.Clin 'er" *00. @o!+*(--):-?#5.""

5? pacientes" 40% mejor en - semana,5? pacientes" 40% mejor en - semana,4% en 4 semanas4% en 4 semanas C/rr ed Res Opin" *005 >/l+*-():-05#C/rr ed Res Opin" *005 >/l+*-():-05#.4.4


6/23

CsA 0,05Blagrimas !=sCsA 0,05Blagrimas !=s

Lagrimas en ojo seco B LALagrimas en ojo seco B LA Lagrimas !=s CsA 0,05 B lagrimasLagrimas !=s CsA 0,05 B lagrimas

iniciado - mes antes de LA,iniciado - mes antes de LA,

s/spendido ?' post LA, reiniciado $s/spendido ?' post LA, reiniciado $mantenido 4 meses "mantenido 4 meses " Am1os gr/pos mejoraron ojo seco, peroAm1os gr/pos mejoraron ojo seco, pero

CsA o1t/!o res/ltado reracti!oCsA o1t/!o res/ltado reracti!o

signicati!amente mas cercano alsignicati!amente mas cercano alo1jeti!o a los 4 $ . meses post LAo1jeti!o a los 4 $ . meses post LA (9(9D "00)D "00) > Cataract Reract /rg" *00. a$+4*(5):*#> Cataract Reract /rg" *00. a$+4*(5):*#


7/23

8/eratoconj/nti!itis !ernal8/eratoconj/nti!itis !ernal

/ltiple st/dies on t'e eEcac$ o topical CsA or treating/ltiple st/dies on t'e eEcac$ o topical CsA or treating!ernal Feratoconj/ncti!itis 'a!e consistentl$ s'oGn a!ernal Feratoconj/ncti!itis 'a!e consistentl$ s'oGn a1enecial eHect o t'e dr/g" 'e impro!ement tooF an1enecial eHect o t'e dr/g" 'e impro!ement tooF ana!erage o * GeeFs /sing -% or *% CsA in oil sol!ents, o/ra!erage o * GeeFs /sing -% or *% CsA in oil sol!ents, o/r

times dail$" 'e d/ration o treatment depends on t'etimes dail$" 'e d/ration o treatment depends on t'eacti!it$ o t'e infammation" A re1o/nd p'enomenonacti!it$ o t'e infammation" A re1o/nd p'enomenonocc/rred soon ater discontin/ation o t'e treatment,occ/rred soon ater discontin/ation o t'e treatment,

indicating t'e need or a sloG taper"indicating t'e need or a sloG taper"6r" >" Op't'almol", Oct6r" >" Op't'almol", Oct*005+ 3: -4.4 # -4."*005+ 3: -4.4 # -4."

'e most eHecti!e dr/gs, steroids, s'o/ld 'oGe!er 1e'e most eHecti!e dr/gs, steroids, s'o/ld 'oGe!er 1ecare/ll$ administered, and onl$ or 1rie periods, to a!oidcare/ll$ administered, and onl$ or 1rie periods, to a!oidsecondar$ de!elopment o gla/coma" A *% sol/tion osecondar$ de!elopment o gla/coma" A *% sol/tion oc$closporine in oli!e oil or in castor oil s'o/ld 1e consideredc$closporine in oli!e oil or in castor oil s'o/ld 1e consideredas an alternati!e"as an alternati!e" $e" *00? Apr+-(?):4?5#5-$e" *00? Apr+-(?):4?5#5-


8/23

8/eratoconj/nti!itis atpica8/eratoconj/nti!itis atpica

Go prospecti!e, randomised, do/1le masFed, place1o controlledGo prospecti!e, randomised, do/1le masFed, place1o controlledtrials, topical CsA Gas o/nd to 1e an eHecti!e and sae treatment intrials, topical CsA Gas o/nd to 1e an eHecti!e and sae treatment in1ot' steroid dependent and steroid resistant cases o atopic1ot' steroid dependent and steroid resistant cases o atopicFeratoconj/ncti!itisFeratoconj/ncti!itis 6r" >" Op't'almol", Oct *005+ 3: -4.4 # -4."6r" >" Op't'almol", Oct *005+ 3: -4.4 # -4." *- patients /sed eit'er topical *% CsA or t'e !e'icle alone o/r times dail$*- patients /sed eit'er topical *% CsA or t'e !e'icle alone o/r times dail$

or 4 mont's, in addition to t'eir /s/al t'erap$ Git' topical corticosteroidsor 4 mont's, in addition to t'eir /s/al t'erap$ Git' topical corticosteroidsand=or mast cell sta1ilisers" 'e great majorit$ o t'e treated patients Gereand=or mast cell sta1ilisers" 'e great majorit$ o t'e treated patients Gerea1le to discontin/e t'eir topical steroid treatment"a1le to discontin/e t'eir topical steroid treatment"

*0 patients Git' topical steroid resistant, se!ere atopic*0 patients Git' topical steroid resistant, se!ere atopicFeratoconj/ncti!itis+ t'e$ 'ad moderatel$ acti!e disease despite topicalFeratoconj/ncti!itis+ t'e$ 'ad moderatel$ acti!e disease despite topicalsteroid t'erap$ Git' or Git'o/t mast cell sta1ilisers (nedocromil,steroid t'erap$ Git' or Git'o/t mast cell sta1ilisers (nedocromil,lodo;amide)" reatment (CsA or place1o) lasted or * da$s Git' a dosinglodo;amide)" reatment (CsA or place1o) lasted or * da$s Git' a dosingsc'ed/le o si; times dail$ d/ring t'e rst * GeeFs and o/r times dail$sc'ed/le o si; times dail$ d/ring t'e rst * GeeFs and o/r times dail$

d/ring t'e last * GeeFs" ignicant impro!ement Gas o1ser!ed in t'e CsAd/ring t'e last * GeeFs" ignicant impro!ement Gas o1ser!ed in t'e CsAgro/p, and none o t'ese patients 'ad a Gorsening o t'e disorder, ingro/p, and none o t'ese patients 'ad a Gorsening o t'e disorder, incontrast Git' t'e place1o gro/pcontrast Git' t'e place1o gro/p

opical CsA seems to 1e an eHecti!e steroid sparing agent in patientsopical CsA seems to 1e an eHecti!e steroid sparing agent in patientsGit' se!ere atopic Feratoconj/ncti!itis" IoGe!er, its eEcac$ as a rstGit' se!ere atopic Feratoconj/ncti!itis" IoGe!er, its eEcac$ as a rstline agent d/ring long term treatment Garrants additional st/dies"line agent d/ring long term treatment Garrants additional st/dies"


9/23

Randomised controlled trial o topicalRandomised controlled trial o topicalciclosporin A in steroid dependent allergicciclosporin A in steroid dependent allergic

conj/ncti!itis"conj/ncti!itis"

6r > Op't'almol" *00. Apr+30(?):?.-#?"6r > Op't'almol" *00. Apr+30(?):?.-#?" 9rospecti!e, randomised, do/1le masFed, place1o9rospecti!e, randomised, do/1le masFed, place1o

controlled trial comparing signs, s$mptoms, and t'e a1ilit$controlled trial comparing signs, s$mptoms, and t'e a1ilit$to red/ce or stop conc/rrent steroid in steroid dependentto red/ce or stop conc/rrent steroid in steroid dependent

atopic Feratoconj/ncti!itis and !ernal Feratoconj/ncti!itisatopic Feratoconj/ncti!itis and !ernal Feratoconj/ncti!itis/sing 0"05% topical ciclosporin A !=s place1o"/sing 0"05% topical ciclosporin A !=s place1o" ?0 patients, - Git' atopic Feratoconj/ncti!itis and ** Git'?0 patients, - Git' atopic Feratoconj/ncti!itis and ** Git'

!ernal Feratoconj/ncti!itis!ernal Feratoconj/ncti!itis @o statistical signicant diHerence in dr/g score,@o statistical signicant diHerence in dr/g score,

s$mptoms, or clinical signs scores 1etGeen t'e place1o ands$mptoms, or clinical signs scores 1etGeen t'e place1o andciclosporin gro/pciclosporin gro/p

@o RA&s@o RA&s


10/23

opical c$closporine in t'e management oopical c$closporine in t'e management os'ield /lcers"s'ield /lcers"

Cornea" *00? ar+*4(*):-3?#*00Cornea" *00? ar+*4(*):-3?#*00"" *%#0"05% (decreasing concentration) 8< topical*%#0"05% (decreasing concentration) 8< topical

c$closporine in t'e treatment o ? cases o se!ere,c$closporine in t'e treatment o ? cases o se!ere,corticosteroid#resistant, !ernal Feratoconj/ncti!itiscorticosteroid#resistant, !ernal Feratoconj/ncti!itis

Git' s'ield /lcers"Git' s'ield /lcers" Iealing o /lcers occ/rred in -0 da$s Git' t'e *%Iealing o /lcers occ/rred in -0 da$s Git' t'e *%

concentration in all cases" @o side eHects e;ceptconcentration in all cases" @o side eHects e;ceptor a 1/rning sensation d/ring administration"or a 1/rning sensation d/ring administration"Rec/rrences occ/rred G'en t'e concentration GasRec/rrences occ/rred G'en t'e concentration Gas

decreased to 0"05% in 4 cases" 'e rec/rrencesdecreased to 0"05% in 4 cases" 'e rec/rrencesGere eHecti!el$ treated Git' -% concentration inGere eHecti!el$ treated Git' -% concentration inall cases, and patients Gere sta1le Git' t'isall cases, and patients Gere sta1le Git' t'isconcentration or at least . mont's"concentration or at least . mont's"


11/23

opical c$closporine A in se!ere steroid#dependentopical c$closporine A in se!ere steroid#dependentc'ild'ood p'l$cten/lar Feratoconj/ncti!itis"c'ild'ood p'l$cten/lar Feratoconj/ncti!itis"

Am > Op't'almol" *00. >an+-?-(-):.*#.."Am > Op't'almol" *00. >an+-?-(-):.*#.." C'ildren (-4 e$es, mean age 3 $ears) Git' p'l$cten/larC'ildren (-4 e$es, mean age 3 $ears) Git' p'l$cten/lar

Feratoconj/ncti!itis associated Git' se!ere steroid#dependentFeratoconj/ncti!itis associated Git' se!ere steroid#dependentcorneal infammation and not responding to oral anti1ioticscorneal infammation and not responding to oral anti1iotics(c$clines or er$t'rom$cin)(c$clines or er$t'rom$cin)

opical CsA *% o/r times dail$, initiall$ com1ined Git' topicalopical CsA *% o/r times dail$, initiall$ com1ined Git' topicalde;amet'asone or t'e rst GeeF" C$closporinemia Gasde;amet'asone or t'e rst GeeF" C$closporinemia Gasdetermined e!er$ 4 mont'sdetermined e!er$ 4 mont's

nfammation Gas controlled in all t'e e$es Git'in -? da$snfammation Gas controlled in all t'e e$es Git'in -? da$s""nfammation did not rec/r d/ring CsA monot'erap$, d/ring anfammation did not rec/r d/ring CsA monot'erap$, d/ring amean olloG#/p o -* B=# mont'smean olloG#/p o -* B=# mont's

CsA t'erap$ Gas stopped in eig't patients (-0 e$es) ater a meanCsA t'erap$ Gas stopped in eig't patients (-0 e$es) ater a mean

treatment d/ration o -4 B=# 3 mont's (range, . to 4- mont's),treatment d/ration o -4 B=# 3 mont's (range, . to 4- mont's),and no rec/rrences occ/rred d/ring -0 B=# 4 mont's o olloG#/pand no rec/rrences occ/rred d/ring -0 B=# 4 mont's o olloG#/p Local tolerance o CsA Gas good" @one o t'e patients 'adLocal tolerance o CsA Gas good" @one o t'e patients 'ad

detecta1le CsA 1lood le!els" CsA Gas Git'draGn in one case aterdetecta1le CsA 1lood le!els" CsA Gas Git'draGn in one case ater. mont's, 1eca/se o generali2ed sFin ras'. mont's, 1eca/se o generali2ed sFin ras'


12/23

8/eratitis central o paracentral8/eratitis central o paracentral

no inecciosano inecciosa mm/ne mediated, sterile central or paracentral cornealmm/ne mediated, sterile central or paracentral corneal

/lceration ma$ de!elop in patients Git' connecti!e tiss/e/lceration ma$ de!elop in patients Git' connecti!e tiss/edisease, most commonl$ indisease, most commonl$ in r'e/matoid art'ritis orr'e/matoid art'ritis orjJgrenKs diseasejJgrenKs disease" 'ese conditions need to 1e" 'ese conditions need to 1e

disting/is'ed rom perip'eral /lcerati!e Feratitis (97),disting/is'ed rom perip'eral /lcerati!e Feratitis (97),1eca/se 97 is essentiall$ a !asc/litis o lim1al 1lood1eca/se 97 is essentiall$ a !asc/litis o lim1al 1lood!essels and is considered to 1e associated Git'!essels and is considered to 1e associated Git'(re)acti!ation o s$stemic illness" 7nliFe 97, t'e(re)acti!ation o s$stemic illness" 7nliFe 97, t'ecentral=paracentral /lcerations ma$ not respond Gell tocentral=paracentral /lcerations ma$ not respond Gell tos$stemic imm/nos/ppressi!e t'erap$"s$stemic imm/nos/ppressi!e t'erap$"

e!eral small, /ncontrolled case series 'a!e reported t'ee!eral small, /ncontrolled case series 'a!e reported t'e1enecial eHect o topical CsA in treating paracentral1enecial eHect o topical CsA in treating paracentralcorneal /lcers associated Git' connecti!e tiss/e disease"corneal /lcers associated Git' connecti!e tiss/e disease"((*% or 0"5% CsA, o/r to si; times dail$)*% or 0"5% CsA, o/r to si; times dail$) 6r" >" Op't'almol", Oct6r" >" Op't'almol", Oct*005+ 3: -4.4 # -4."*005+ 3: -4.4 # -4."


13/23

Otras indicaciones seg/nOtras indicaciones seg/n

6>O6>O 8/eratitis p/nctata s/percial de '$geson8/eratitis p/nctata s/percial de '$geson:: saesae

alternati!e, partic/larl$ or patients G'o Gill re/irealternati!e, partic/larl$ or patients G'o Gill re/irelong term topical steroid treatment"long term topical steroid treatment"

Conj/nti!itis leMosaConj/nti!itis leMosa:: small, /ncontrolled casesmall, /ncontrolled caseindicated impro!ement in reractor$ LC"indicated impro!ement in reractor$ LC" Li/en plano conj/nti!al:Li/en plano conj/nti!al:6eca/se o its a1ilit$ to6eca/se o its a1ilit$ to

accelerate apoptosis in 1rotic tiss/es, topical CsAaccelerate apoptosis in 1rotic tiss/es, topical CsAalone Gas /sed in a eG patients 'a!ing conj/ncti!alalone Gas /sed in a eG patients 'a!ing conj/ncti!alin!ol!ement rom lic'en plan/s, and pro!edin!ol!ement rom lic'en plan/s, and pro!ed

eHecti!e in controlling infammation and scarringeHecti!e in controlling infammation and scarring Conj/nti!itis lim1ica s/periorConj/nti!itis lim1ica s/perior:: topical CsA ma$ 1etopical CsA ma$ 1e

/sed or 1ot' increasing tear prod/ction and/sed or 1ot' increasing tear prod/ction andcontrolling infammation"controlling infammation"


14/23

9re!encin rec'a2o transplante9re!encin rec'a2o transplante

cornealcorneal 5* ; de 1ajo riesgo"5* ; de 1ajo riesgo" CsA 0,05% iniciada -#-0 semanas post#;CsA 0,05% iniciada -#-0 semanas post#;

- s/1gr/po con p/lsos prednisolona -% ;- s/1gr/po con p/lsos prednisolona -% ;? ; ? dias, cada . semanas? ; ? dias, cada . semanas

9rednisolona sola: menos rec'a2o /e CsA9rednisolona sola: menos rec'a2o /e CsA

CsA sola: menos rec'a2o /e 9rednisolonaCsA sola: menos rec'a2o /e 9rednisolonap/lsos B CsAp/lsos B CsA Op't'almolog$" *00. Oct+--4(-0):-5#30Op't'almolog$" *00. Oct+--4(-0):-5#30


15/23

Rec'a2o corneal: sinRec'a2o corneal: sin

em1argo"""em1argo""" 9re!ention and treatment o corneal grat rejection: c/rrent practice9re!ention and treatment o corneal grat rejection: c/rrent practice

patterns (*00?# 'e Cornea ociet$)patterns (*00?# 'e Cornea ociet$) Cornea" *00. Apr+*5(4):*.#30"Cornea" *00. Apr+*5(4):*.#30"

All respondents /sed topical corticosteroids or ro/tine postoperati!eAll respondents /sed topical corticosteroids or ro/tine postoperati!emanagement and treatment o endot'elial grat rejection"management and treatment o endot'elial grat rejection"9rednisolone, in 1rand or generic orm, Gas /sed 1$ 4 to 30% or9rednisolone, in 1rand or generic orm, Gas /sed 1$ 4 to 30% orro/tine management in !ario/s clinical scenarios and - to 3-% orro/tine management in !ario/s clinical scenarios and - to 3-% or!ario/s maniestations o grat rejection at all time points+ 'oGe!er,!ario/s maniestations o grat rejection at all time points+ 'oGe!er,ater . mont's, -* to *.% /sed loteprednol eta1onate or ro/tineater . mont's, -* to *.% /sed loteprednol eta1onate or ro/tinemanagement"management" Nor ro/tine management o 'ig'#risF grats, ?% /sedNor ro/tine management o 'ig'#risF grats, ?% /sedtopical c$closporine in addition to prednisolone"topical c$closporine in addition to prednisolone" Compared Git'Compared Git'pre!io/s s/r!e$s, t'e /se o oral steroids signicantl$ decreased orpre!io/s s/r!e$s, t'e /se o oral steroids signicantl$ decreased or

t'e ro/tine management o 'ig'#risF corneal transplants, and t'e /set'e ro/tine management o 'ig'#risF corneal transplants, and t'e /seo s/1conj/ncti!al steroids decreased or t'e management o grato s/1conj/ncti!al steroids decreased or t'e management o gratrejectionrejection

opical prednisolone remains t'e mainsta$ or t'e pre!ention andopical prednisolone remains t'e mainsta$ or t'e pre!ention andtreatment o corneal grat rejection+ 'oGe!er,treatment o corneal grat rejection+ 'oGe!er, t'e role o neGert'e role o neGeragents, loteprednol eta1onate and topical c$closporine, is e;panding"agents, loteprednol eta1onate and topical c$closporine, is e;panding"


16/23

8/eratitis estromal /e no8/eratitis estromal /e no

responde a prednisolona -%responde a prednisolona -% -* ojos con 8 no necroti2ante /e no-* ojos con 8 no necroti2ante /e no

respondieron a prednisolona -%=? semanasrespondieron a prednisolona -%=? semanas CsA 0,05 6


17/23


18/23

8/eratopatia ne/rotroca8/eratopatia ne/rotroca

tempranatemprana - paciente con /eratitis I#- a- paciente con /eratitis I#- a

repeticin $ /eratopatia ne/rotrocarepeticin $ /eratopatia ne/rotroca

sec/ndaria (deecto epitelial p/ntiorme)sec/ndaria (deecto epitelial p/ntiorme) st/!o . meses con LC terape/tica,st/!o . meses con LC terape/tica,

lagrimas $ anti1ioticos, sin resp/esta"lagrimas $ anti1ioticos, sin resp/esta" CsA 0,05 6


19/23

Ecac$ o topical c$closporin 0"05% in t'eEcac$ o topical c$closporin 0"05% in t'etreatment o posterior 1lep'aritis"treatment o posterior 1lep'aritis"

> Oc/l 9'armacol 'er" *00. Ne1+**(-):?#54"> Oc/l 9'armacol 'er" *00. Ne1+**(-):?#54" C$closporin 0"05% op't'almic em/lsion !ers/s to1ram$cinC$closporin 0"05% op't'almic em/lsion !ers/s to1ram$cin

0"4%=de;amet'asone 0"-%0"4%=de;amet'asone 0"-% 9osterior 1lep'aritis impro!ed signicantl$ rom t'e initial9osterior 1lep'aritis impro!ed signicantl$ rom t'e initial

st/d$ !isit Git' 1ot' c$closporin treatment andst/d$ !isit Git' 1ot' c$closporin treatment andto1ram$cin=de;amet'asone"to1ram$cin=de;amet'asone" C$closporin pro!ided greater impro!ements in c'irmerQsC$closporin pro!ided greater impro!ements in c'irmerQs

scores (9 0"00-), e$elid 'ealt' (p0"0-5), and tear 1reaF#scores (9 0"00-), e$elid 'ealt' (p0"0-5), and tear 1reaF#/p time (9 D 0"0-) t'an to1ram$cin=de;amet'asone ater/p time (9 D 0"0-) t'an to1ram$cin=de;amet'asone ater

-* GeeFs o treatment"-* GeeFs o treatment" A 'ig'er percentage o patients in t'e c$closporin treatmentA 'ig'er percentage o patients in t'e c$closporin treatment

gro/p 'ad impro!ements in s$mptoms o 1l/rred !ision,gro/p 'ad impro!ements in s$mptoms o 1l/rred !ision,1/rning, and itc'ing and resol/tion o lid telangiectasia1/rning, and itc'ing and resol/tion o lid telangiectasia


20/23

Carcinoma escamoso corneal $Carcinoma escamoso corneal $

conj/nti!alconj/nti!al * pacientes con 1ordes de reseccion* pacientes con 1ordes de reseccion

inltrados: Csa 0,05% 8< ; -*inltrados: Csa 0,05% 8< ; -*

semanas B C 0"0-% 8< en *, ?semanas B C 0"0-% 8< en *, ?$ . semanas"$ . semanas"

@o rec/rrencias a - meses@o rec/rrencias a - meses Am >Am >

Op't'almol" *00. Oct+-?*(?):.4#5Op't'almol" *00. Oct+-?*(?):.4#5


21/23

ntonces"""ntonces"""

6enecio indisc/ti1le en ojo seco moderado=se!ero6enecio indisc/ti1le en ojo seco moderado=se!ero 6enecio pro1a1le:6enecio pro1a1le:

Alergias oc/lares cronicas (ernal=Atopica)Alergias oc/lares cronicas (ernal=Atopica) 8/eratitis paracentrales no inecciosas8/eratitis paracentrales no inecciosas 8/eratitis estromal no necroti2ante8/eratitis estromal no necroti2ante '$geson'$geson Conj/nti!itis lim1ica s/periorConj/nti!itis lim1ica s/perior Li/en plano conj/nti!alLi/en plano conj/nti!al 6learitis posterior6learitis posterior

8/eratoconj/nti!itis ficten/lar8/eratoconj/nti!itis ficten/lar Conj/nti!itis leMosaConj/nti!itis leMosa nteresante: mejoro predicti1ilidad reracti!a LAnteresante: mejoro predicti1ilidad reracti!a LA 7nico RA: esco2or -?%"7nico RA: esco2or -?%"


22/23

Indicaciones de Ciclosporina tpica 0,05% (Restasis, AllerganIndicaciones de Ciclosporina tpica 0,05% (Restasis, Allergan))

1.-Ojo seco1.-Ojo seco(* !eces=dia, d/racin indenida)(* !eces=dia, d/racin indenida) #ncl/sin:#ncl/sin:

Ojo seco moderado a se!ero, con resp/esta ins/ciente a l/1ricacin"Ojo seco moderado a se!ero, con resp/esta ins/ciente a l/1ricacin"

#;cl/sion:#;cl/sion: Ojo seco m/$ se!ero (c'irmer con anestesia menor a 4mm)Ojo seco m/$ se!ero (c'irmer con anestesia menor a 4mm) neccin acti!aneccin acti!a Lentes de contactoLentes de contacto apones p/nctalesapones p/nctales

2.-Qeratoconjnti!itis !ernal2.-Qeratoconjnti!itis !ernal(? !eces=dia, 'asta resol/cion infamacin, inicio de(? !eces=dia, 'asta resol/cion infamacin, inicio demejorSa a las * semanas, retirada grad/al)mejorSa a las * semanas, retirada grad/al)

".-Qeratoconjnti!itis atopica".-Qeratoconjnti!itis atopica(.#? !eces=dia, -#4 meses)(.#? !eces=dia, -#4 meses)


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ciclosporina tópica2

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