Effect Of Topical Tacrolimus On Subepithelial Infiltrates Secondary To Adenoviral Keratoconjunctivitis

To investigate the topical tacrolimus in the treatment of subepithelial infiltrates (SEI) secondary to adenoviral keratoconjunctivitis.

In this retrospective study, the data of patients who developed SEI due to adenoviral keratoconjunctivitis and

 were primarily used topical tacrolimus ointment (0.03%) were analyzed. Patients used topical tacrolimus

 ointment on their eyelids once a day. Time to appearance of subepithelial infiltrates, duration of treatment, 

best-corrected visual acuity (BCVA) before and after treatment, SEI treatment status, and 

subjective symptom score were evaluated. In the subjective symptom score, patients' complaints were 

scored between 0-3. 

Twenty-two patients (30 eyes) were included in the study.  Pre-treatment BCVA was 0.4 ± 0.21 (0-0.4) logMAR and after treatment

 0.02 ± 0.05 (0-0.2) logMAR (p<0.001). The mean application time of tacrolimus ointment was 

24.30 ± 13.77 (10-60) days. SEI disappeared completely in 95% (28 eyes) of the patients, and 

the number of SEIs decreased in 5% (2 eyes). Tacrolimus intolerance was not detected in any of the 

patients. SEI recurrence was detected in two patients (6.66%) 1 month after discontinuing tacrolimus, 

topical tacrolimus was started again and the treatment duration was extended to 2 months. While the

 mean subjective symptom score was 2.33 ± 0.80 (1-3) before treatment, it was 0.1 ± 0.3 (0-1) after

 treatment (p<0.001).

Topical tacrolimus ointment is an effective method in the treatment of SEI due to adenoviral 

keratoconjunctivitis. It can be an alternative to steroid use in the early period due to the absence of side 

effects such as increased intraocular pressure and cataract development.