The aim of this study was to evaluate whether the control of ocular symptoms with cyclosporine or with tacrolimus in eye drops allows to improve sun exposure and therefore serum level of vitamin D (VD; 25OHD), in the more severe forms of vernal keratoconjunctivitis (VKC). Out of 242 children followed for active VKC, 94 were treated with 1% cyclosporine or 0.1% tacrolimus eye drops, while the other 148 with mild VKC did not need to be treated with immunomodulators. VD serum levels were measured in spring and autumn in 71 children. In total, 60 of them were treated with cyclosporine eye drops (first group) and 11 (not responding to cyclosporine therapy previously) with 0.1% tacrolimus eye drops (second group) between March and November 2016. Pre-treatment median values of VD were 23.7 ng/mL in the first group and 23.8 in the second group, and post-treatment values increased up to 32.8 and 32.9 ng/mL, respectively. Before treatment, 33% presented a deficiency (25OHD < 20 ng/mL), and at the end of summer, only 4% were deficient. The overweight children had lower improvement in VD serum levels than children with a body mass index (BMI) lower than 85th percentile. Children in therapy with cyclosporine, but requiring the administration of local steroid therapy during the summer for control of the symptoms, showed a greater improvement in 25OHD serum levels in ng/mL (23-37 ng/mL) than children who did not require steroid therapy (24-35 ng/mL). Furthermore, there was a significant difference in change of 25OHD in children presenting limbal VKC (21-41 ng/mL) versus tarsal VKC (24-35 ng/mL) ( P = 0.04). Our study suggests that ocular treatment carried out with immunomodulator eye drops could allow for an improvement in 25OHD serum levels. In children with active VKC and at risk of 25OHD deficiency, likely due to avoidance of sun exposure, the role of other risk factors (BMI, phototype and treatment) on 25OHD serum levels should be considered.

中文翻译：

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春季角膜结膜炎和疾病控制患儿的维生素D血清水平

这项研究的目的是评估用环孢霉素或他克莫司滴眼液控制眼部症状是否可以改善阳光照射，从而在更严重的春季角膜结膜炎（VKC）中改善维生素D（VD; 25OHD）的血清水平。 ）。在242名接受主动VKC治疗的儿童中，有94名接受了1％环孢素或0.1％他克莫司滴眼液的治疗，而其他148名患有轻度VKC的儿童则不需要免疫调节剂治疗。在春季和秋季测量了71名儿童的VD血清水平。在2016年3月至2016年11月之间，总共60例患者接受了环孢素滴眼液（第一组）治疗，其中11例（先前对环孢素治疗无反应）接受了0.1％他克莫司滴眼液（第二组）治疗。治疗前的VD中位数为第一组为23.7 ng / mL，第二组为23.8 ng / mL，和后处理值分别增加至32.8和32.9 ng / mL。在治疗前，有33％的人缺乏（25OHD <20 ng / mL），夏季末只有4％的人缺乏。与体重指数（BMI）低于85％的儿童相比，超重儿童的VD血清水平改善较低。接受环孢菌素治疗但需要在夏季进行局部类固醇治疗以控制症状的儿童，与不需要类固醇的儿童相比，其25OHD血清ng / mL（23-37 ng / mL）的改善更大。治疗（24-35 ng / mL）。此外，表现为角膜缘VKC（21-41 ng / mL）的儿童与状VKC（24-35 ng / mL）的儿童的25OHD变化存在显着差异（P = 0.04）。我们的研究表明，用免疫调节剂滴眼液进行眼部治疗可以改善25OHD血清水平。对于活动性VKC且有25OHD缺乏症风险的儿童（可能是由于避免日晒），应考虑其他危险因素（BMI，照相类型和治疗）对25OHD血清水平的作用。