Ricerc@Sapienza

Abstract
Background: Vernal keratoconjunctivitis (VKC) is a rare chronic conjunctivitis characterized
by a predominantly eosinophil-mediated inflammatory disorder that could
develop critical complications such as blindness. Oxidative stress plays a pivotal role
in the pathogenesis of several allergic diseases. The role of oxidative stress has been
hypothesized in VKC, but no study explored this issue. Furthermore, cyclosporine A
(CsA) exerts an anti-inflammatory and antioxidant action on the conjunctiva.
This study aimed to assess the oxidative stress in VKC patients and controls and to
study the effect of CsA on oxidative stress in these subjects.
Methods: Thirty-six consecutive children, including 12 VKC (nine males, 75%; mean
age 10.17; SD ± 2.48) patients without treatment, 12 VKC patients treated with CsA
(nine males, 75%; mean age 9.08; SD ± 2.75), and 12 controls (CT) (seven males, 58%;
mean age 8.58; SD ± 1.78), were recruited. A cross-sectional study was performed to
compare H2O2 in the serum with that in the tears of these children.
Results: Compared with CT and VKC children treated with CsA, VKC untreated children
had significantly higher values of hydrogen peroxide (H2O2) in the serum and the
tears. No significant differences were observed between CT and VKC treated with
CsA. A significant correlation was found at the linear regression analysis between
serum and tear H2O2 levels.
Conclusion: This study provides the first report attesting that patients with VKC have
high oxidative stress; furthermore, it suggests that CsA could have an anti-inflammatory
and antioxidant action that could be useful to prevent the poor VKC outcome.