Topical tacrolimus may effectively reduce clinical signs and symptoms of noninfectious, non-necrotizing anterior scleritis in cases that are unresponsive to topical steroids, a recent study suggested.

This prospective, single-arm study included nine patients (four men and five women) with anterior scleritis who were a mean of 59.4 years old. Each participant was treated with steroids for one month before switching to 0.1% tacrolimus eye drops. A team scored hyperemia and pain before and after each treatment and measured intraocular pressure (IOP) during.

The investigators found that hyperemia and pain significantly decreased from baseline by one week after initiating tacrolimus eye drops. With steroid treatment, however, they did not observe a significant reduction in hyperemia or pain throughout the first month.

They also reported statistically significant decreases in mean IOP over the course of treatment with tacrolimus eye drops; however, the researchers were unable to determine if the change in IOP was due to the discontinuation of the steroid or the initiation of tacrolimus. In the same group, they added that no additional medications were required to provide relief and no infectious adverse events were documented.

The study was limited by its small sample size and the lack of a washout period between treatment regimens, the researchers noted in their paper.

The study authors concluded that, “0.1% tacrolimus eye drops demonstrated immediate beneficial effects on clinical outcomes in patients with noninfectious and non-necrotizing anterior scleritis refractory to standard conventional steroid treatments.”

Yazu H, Miyazaki D, Fujishima H. Experience with 0.1% tacrolimus eye drop for noninfectious, non-necrotizing anterior scleritis. Eye Cont Lens. May 12, 2020. [Epub ahead of print].