It’s never too late to give something else a try. Researchers recently found that topical tacrolimus 0.03% might be effective against persistent subepithelial infiltrates (SEIs) secondary to adenoviral keratoconjunctivitis (AKC).

In a consecutive case series, the researchers examined 15 eyes of 11 patients with SEIs secondary to AKC who were resistant to topical steroids and cyclosporine-A and being treated with topical tacrolimus 0.03% for 12 months, at least two years after AKC diagnosis. The control group included 16 eyes of 16 healthy patients.

Best-corrected visual acuity (BCVA), Fantes score, corneal SEI score, Oxford score, Schirmer and tear break-up time results were evaluated at baseline and at each follow-up for 12 months. Although one patient could not tolerate the therapy, the remaining patients experienced significant improvements the test measures, beginning at the three-month follow-up. The positive results persisted until the end of the 12-month study period.

“A period of three months was necessary for a significant improvement in BCVA, SEIs and Shirmer results,” the study authors note. “A period of six months was necessary for a decrease in Oxford score.” The researchers say topical tacrolimus 0.03% may show efficacy against resistant SEIs. 

Arici G, Mergen B. Late-term topical tacrolimus for subepithelial infiltrates resistant to topical steroids and cilosporin secondary to adenoviral keratoconjunctivitis. Br J Ophthalmology 2020. [Epub ahead of print].