Topical cyclosporine A 0.05% for recurrent anterior uveitis
Reviewed by Jonathan Chan

This is a retrospective case-crossover study conducted by reviewing medical charts of patients treated for recurrent anterior uveitis between 2002 and 2011 at the Kellogg Eye Centre by one cornea specialist. The demographics, episodes of anterior uveitis, severity of episodes and treatment modalities before and after initiation of cyclosporine A (CSA) 0.05% were reported. A total of eight patients were identified as having been treated with topical CSA in addition to standard treatment with an average follow-up of 54.9±33.9 months (range: 28-143 months). The patients had statistically significant fewer episodes of anterior uveitis, shorter duration and fewer total days of inflammation per year while on topical CSA. Patients were found to have an average of 3.6±2.0 recurrences prior to initiation of CSA. There was a significant difference in the average number of episodes per year while on conventional treatment compared with while on treatment with topical CSA (4.3 vs. 0.36, p<0.05). The duration was also shorter while on CSA compared with conventional treatment (41.6 days vs. 13.3 days, p<0.005). Only one patient reported stinging with CSA instillation; this effect was not severe enough to require discontinuation of the medication. Another patient discontinued cyclosporine because she had been free of recurrence for 10 months; however, she presented with a flare of anterior uveitis one month after this discontinuation. The authors concluded that this study showed improvement of recurrent anterior uveitis in patients while on conventional treatment with CSA compared with conventional treatment alone. The authors also commented that the limitations of this study include that it is a small retrospective chart review in which the treatment regimens were not standardised. In addition, the clinician was not masked to the patient’s treatment and thus grading of anterior chamber cell was subject to bias.

Topical cyclosporine A 0.05% for recurrent anterior uveitis.
Prabhu SS, Shtein RM, Michelotti MM, Cooney TM.
BRITISH JOURNAL OF OPHTHALMOLOGY
2016;100:345-7.