Vernal Kerataconjunctivitis Treated With Omalizumab: a serie of cases

Vernal keratoconjunctivitis (VKC) is considered a severe form of conjunctival allergic disease. The quality of life is severely impaired and treatment is complex and poorly responsive. The objective of this study was to evaluate the ophthalmologic clinical improvement with the use of omalizumab (OM). Evaluation of three patients in the use of OM with objective score (OS - up to 8) and subjective (SS - up to 10) score (Spadavecchia et al., 2006) for clinical evaluation on days 0 and 180 and also the evaluation of the allergen sensitization performed through ImmunoCAP ISAC®. Patient 1, male, 6 years; patient 2, female, 23 years; patient 3, male, 15 years. All with allergic rhinitis, severe asthma and VKC refractory to classic therapies, including oral immunosuppression and immunotherapy. All patients presented significant sensitivity to mites (nDer p1 and rBlo t5). The OM was indicated for asthma in regular doses. Regarding the scores: the initial values were SO 7 and SS 9,5; SO 7.5 and SS 8; SO 8 and SS 10. After 180 days of treatment with OM, the values were 4/5; 3/5; 4,5 / 4 respectively. Significant decrease in asthma symptoms and allergic rhinitis was also observed. OM is a humanized monoclonal antibody that binds circulating free IgE, thereby controlling the inflammatory process. In the reported cases, improvement in ocular symptoms was evident, but further studies are needed to prove the efficacy and safety of OM in VKC.