Long-term topical cyclosporin A therapy in Thygeson's superficial punctate keratitis: a case report

Murat Hasanreisoglu,Rahamim Avisar

doi:10.1186/1757-1626-1-415

Abstract

PurposeTo describe a patient with Thygeson's superficial punctate keratitis successfully treated with long-term cyclosporin A.Case presentationA 15-year-old boy presented with long-term ocular symptoms of foreign body sensation, burning, irritation, tearing, and transient photophobia. One year's treatment with steroidal agents had led to only partial improvement. Clinical and laboratory evaluation yielded a diagnosis of Thygeson's superficial punctate keratitis. Treatment with 0.5% topical cyclosporin A for the last 4.5 years has been associated with symptom resolution and corneal clearing, without side effects.ConclusionTopical cyclosporin A seems to effective and safe for the treatment of Thygeson's superficial punctuate keratitis and should be considered in selective cases when topical steroids fail or in there is a high risk of complications from long-term steroid treatment. Considering the chronicity of Thygeson's superficial punctate keratitis, further prospective studies of long-term cyclosporine A treatment are needed.

Highlights

Topical cyclosporin A seems to effective and safe for the treatment of Thygeson's superficial punctuate keratitis and should be considered in selective cases when topical steroids fail or in there is a high risk of complications from long-term steroid treatment
In 1950, Thygeson was the first to describe the clinical entity of transient, bilateral, coarse corneal epithelial opacities, without associated stromal involvement or corneal edema, which was later termed Thygeson's superficial punctate keratitis (TSPK) [1]
A diagnosis of TSPK was made on the basis of the clinical appearance of bilateral superficial punctuate epithelial keratopathy with minimal conjunctival reaction, the chronicity of the disease with remissions and exacerbations, and the partial response to topical corticosteroids

Summary

Conclusion

Topical cyclosporin A seems to effective and safe for the treatment of Thygeson's superficial punctuate keratitis and should be considered in selective cases when topical steroids fail or in there is a high risk of complications from long-term steroid treatment. Considering the chronicity of Thygeson's superficial punctate keratitis, further prospective studies of long-term cyclosporine A treatment are needed

Introduction

Discussion

Thygeson P

Kahan BD