Ciclosporin A in ophthalmology: A systematic review

Abstract

Aim: To systematically analyse data from randomized controlled trials of topical Ciclosporin with the aim of assessing the uses and effectiveness of Ciclosporin in different conditions, optimal dosage and adverse effect profile. Methods: 24 RCTs that had evaluated the uses and efficacy of Ciclosporin in different ocular conditions were selected and were used in this review. Articles published upto December 2018 were identified from the following sources- Medline, Scopus, Web of science and references from relevant articles. Results: The average JADAD score was 3.16. Symptomatic relief and objective improvement of ocular signs were noted in most cases of allergic eye disease, moderate to severe dry eye disease and lid margin inflammatory disease. It was also found to accelerate post surgical corneal nerve healing and recovery of corneal sensation. It was not effective in post keratoplasty graft rejection. Adverse effects reported were minimal and included symptoms like ocular stinging. Conclusions: Even though topical Ciclosporin A is an attractive treatment option in many ocular conditions, more structured RCTs are needed to standardize the dose and provide a detailed adverse effect profile.