Is Topical Interferon Alpha-2b Eye Drop Effective in Refractory Vernal Keratoconjunctivitis

Abstract

Purpose: To evaluate the efficacy and safety of topical interferon alpha-2b (IFN alpha-2b)for the treatment of long-standing steroid-resistant and steroid-dependent vernal keratoconjunctivitis (VKC).

Methods:Inthis prospective interventional case series,patients with refractory VKC from one referral center in Rasht, Iran were included. All patients had active symptomatic disease despite conventional medical therapyincluding topical steroids (steroid-resistant group) or were dependent on topical steroids (steroid-dependent group). After discontinuationof all medications for at least 1 week,patients were treated with topical Interferon Alpha-2beye drop at least for 6 months. Changes in subjective symptoms and objective signs were evaluated 1 week,1 and 6 months after treatment. Possible ocular and systemic complications wereevaluated.

Results:Twenty-eight eyes of 14 patients (10males and 4 female) were included. Mean age of the patients was 22 ± 8 years (11 to 38 years).Mean duration of VKC was12 ± 6 years (5 to 23 years). Patients were followed for 10±2 months (6-12 months). All symptoms including itching,burning, redness, photosensitivity, foreign body sensation, and mucus discharge were improved (P<.001).Conjunctival hyperemia was the first sign, which improved 1 week after treatment. Other objective signs including conjunctivalandlimbalpapillary hypertrophy, corneal punctate epithelial erosions, and corneal pannus improved at least one month after treatment. There were not any changes in corneal opacityduring follow-up period (p> 0.05).No ocular or systemic side effect was observed.

Conclusion:Topical IFN alpha-2b eye dropis a safe and effective medication for refractory VKC. It might be better to apply earlier in these cases before occurrence of the complications including irreversible limbal stem cell deficiency,corneal opacity, and steroid-induced complications.