Mayer K., Reinhard T., Reis A., Böhringer D., Sundmacher R.

Eye Clinic, Heinrich-Heine University Düsseldorf

Background: Severe atopic blepharitis is difficult to treat, as topical steroids offer only a limited therapeutic benefit with increasing side effects by time. Topical FK 506 was found to be efficient and safe for the treatment of atopic dermatitis in dermatologic studies. The use of topical FK 506 in atopic blepharitis has not been reported so far.
Methods: Eleven patients with severe atopic blepharitis were treated with topical FK 506 0.1%. The ointment was applied twice daily on the eye lids. Ophthalmologic examinations were scheduled after two and eight weeks. A score was defined for the skin of the lid (edema, erythema, lichenification, oozing, excoriation and crusting) and for the eye lid margin (erythema, thickening, crusting) respectively. Every patient graded pruritus on a visual analogue scale.
Results: The mean skin score prior to treatment was 25.6±6.5, after two weeks 7.5±5.3 (p<0.001) and after eight weeks 6.2±5.1 (p<0.001). The mean score of the eye lid margin prior to treatment was 12.2±4.5, after two weeks 4.4±2.9 (p<0.001) and after eight weeks 4.0±2.4 (p<0.001). The mean score for pruritus prior to treatment was 7.9±1.3, after two weeks 2.1±1.6 (p<0.001) and after eight weeks 1.3±0.9 (p<0.001). All patients assessed the overall situation due to the therapy as markedly improved.
Conclusion: Topical FK 506 0.1% ointment turns out to be an excellent therapeutic option for severe atopic blepharitis. The still open questions of long term dosing and long term safety have to be answered by long term follow-up-studies.

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