On the prevalence of vernal keratoconjunctivitis and current possibilities of treatment
The importance of vernal keratoconjunctivitis (vernal conjunctivitis, or vernal catarrh) is not so much due to its level of prevalence (today its occurrence amounts to 1.25-11.29 per 10 000 population of European countries), but rather to the severity of its clinical course. Especially significant is its tarsal form, which is complicated in 3-11 % of vernal keratoconjunctivitis patients by the development of corneal ulcers. Such patients are normally treated by antiallergic agents, which offer both antihistamine and mast cell-stabilizing action. Primarily, the medicines used are 0.1 % olopatadine and 0.025 % ketotifen, which can also reduce the activation of eosinophils and the production of pro-inflammatory cytokines. The therapy of resistant forms of the disease is successfully supplemented with instillations and / or ointment forms of glucocorticoids, cyclosporine-A, tacrolimus and mitomycin-C. Giant papillae that cause gravitational ptosis or are combined with the torpid current of the disease require surgical treatment. They are excised (or cryodestructed) with intraoperative treatment of the tarsal conjunctiva with 0.02 % mitomycin-C and subsequent instillations of cyclosporine-A. There is a need to further develop and introduce into clinical practice new pathogenetically oriented medicinal preparations which provide both relief of clinical symptoms of the disease and the prevention of its relapses. For citations: Brzheskiy V.V. On the prevalence of vernal keratoconjunctivitis and current possibilities of treatment. Russian ophthalmological journal. 2017; 10 (4): 74-81. doi: 10.21516/2072-0076-2017-10-4-74-81 (in Russian).