Topical Cyclosporin 0.1% Effective in Treating Pediatric Ocular Inflammation: Study

A recent study published in the Nature Scientific Reports demonstrated that topical cyclosporin 0.1% is highly effective in managing ocular surface inflammation caused by allergies and blepharitis in pediatric patients. This finding offers a promising steroid-sparing treatment option for children with vernal and blepharitis-related keratoconjunctivitis, reducing the need for corticosteroids while improving both symptoms and clinical signs.

Ocular surface inflammation, when left untreated or poorly managed, can lead to serious complications, from corneal damage and potential visual impairment. The study assessed the effectiveness of cyclosporin 0.1% eye drops in reducing symptoms and signs of ocular inflammation while reducing the reliance on steroid treatments, which carry potential long-term side effects.

The study included 80 pediatric patients diagnosed with moderate to severe vernal and blepharitis-related keratoconjunctivitis. This research evaluated both subjective symptoms (photosensitivity, itching, discharge, and tearing) and objective clinical signs, including corneal fluorescein staining and papillary hypertrophy. The patients' self-assessments of their condition were also recorded during a comprehensive 6-month follow-up.

The results revealed a marked improvement across all measures. By the end of the follow-up period, all patients treated with topical cyclosporin 0.1% experienced significant relief from symptoms and showed substantial improvements in clinical signs (p < 0.001). The use of rescue steroid treatments dropped dramatically. The average number of steroid courses decreased from 3.71 ± 1.72 before treatment to 0.25 ± 0.49 after 3 months and further declined to 0.13 ± 0.38 by month 6. This significant reduction (p < 0.001 at both time points) indicates that cyclosporin is effective in controlling inflammation and reducing flare-ups that would otherwise require steroid intervention.

Among the allergic group, 96.1% reported a "good" or "rapid and good" therapeutic response, while 96.4% of those with blepharitis-related keratoconjunctivitis shared similar positive outcomes. This high level of effectiveness underlined the potential cyclosporin as a first-line treatment for chronic ocular surface inflammation. A statistical analysis of the entire patient cohort revealed that the likelihood of requiring rescue steroids increased with greater disease severity, as indicated by the Oxford score.

Also, for each unit increase in the Oxford grading scale the odds of needing steroid intervention rose by 1.98 times (95% Confidence Interval: 1.19–3.28, p = 0.008). This finding emphasized the importance of early and aggressive management with cyclosporin to prevent disease progression and reduce dependency on corticosteroids. Overall, topical cyclosporin 0.1% appears to be a safe and effective therapeutic option for pediatric patients with ocular surface inflammation due to allergies and blepharitis.

Source:

Barcsay-Veres, A., Csorba, A., Kovacs, I., Tothfalusi, L., & Maneschg, O. A. (2025). Corticosteroid-sparing topical treatment with cyclosporin for juvenile keratoconjunctivitis. Scientific Reports, 15(1). https://doi.org/10.1038/s41598-025-85256-z