Topical Cyclosporine for Treating Necrotizing Scleritis

Abstract

Anterior scleritis is a serious, potentially sight-threatening inflammatory disease that may present in diffuse, nodular, or necrotizing forms. Topical corticosteroid treatment is often inadequate, and patients with this condition require systemic non-steroidal anti-inflammatory drugs, corticosteroids, or immunosuppressive agents. 1 Systemic cyclosporine has been successfully used for treating severe scleritis, but significant nephrotoxicity, hypertension, hepatoxicity, tremor, hirsutism, and gingival hyperplasia have been associated with its use. 1,2 Recently, topical cyclosporine has been reported to be of benefit in various eye diseases, including scleritis, 2 and we now report another case. Report of a Case. We examined a 68-year-old white woman with a 6-week history of an inflamed right eye that had not responded to a regimen of topical prednisolone acetate and flurbiprofen sodium (0.03%), along with oral indomethacin (25 mg three times a day). She was found to have a large, inflamed superonasal scleral nodule with reactive ptosis ( Figure 1 ). Her