Blepharokeratoconjunctivitis Recurrence Rate Is Higher Than 50% in Children

Treatment for blepharokeratoconjunctivitis (BKC) induced remission in the vast majority of children with the disease; however, recurrence occurred in more than half of those cases, according to research published in Cornea. The findings highlight the need for safe and effective therapeutics for prevention of BKC recurrence in pediatric patients.

The researchers conducted a retrospective chart review of patients aged 15 years or younger who had been diagnosed with BKC between 2004 and 2020 at 2 tertiary hospitals in South Korea. The researchers sought to determine the clinical characteristics, disease course, therapeutic outcomes, and prognostic factors for pediatric patients with BKC.

Their analysis included data on demographics, medical history, ocular findings, geometric profiling of corneal lesions, medical management, and outcomes.

A total of 137 patients (66% women, 34% men), with a mean age of 8.3±3.8 years at disease onset, were included in the study. A slight majority of patients (57.7%) were afflicted in both eyes, and the most common corneal lesions were corneal neovascularization (77.4%), clinically visible corneal infiltration (51.8%), and stromal scarring (43.1%). 

The study shows that 95% of children had disease remission following treatment, with visual acuities improving from 0.2±0.3 logarithm of minimal angle of resolution (logMAR) at disease presentation to 0.1±0.3 logMAR at the final follow up visit (P =.001). 

They also report that recurrence occurred in 52.6% of patients and was associated with significant astigmatism. The cylinder power was 2.5±2.4 D in children with recurrence vs 1.5±1.1 D in those without recurrence (P =.031). 

“[T]he best management option currently available for patients with BKC is careful observation for any recurrence and prompt treatment with topical antibiotics/corticosteroids for alleviation of active inflammation,” the researchers report.