Initial Outcomes Following Treatment With Topical Corticosteroids or Topical Calcineurin Inhibitors in Cats With Eosinophilic Keratitis.

Topical corticosteroids superior to calcineurin inhibitors for feline eosinophilic keratitis control.

This retrospective study evaluated treatment outcomes in 28 cats (32 eyes) with eosinophilic keratitis (EK) treated with either topical corticosteroids (CS, n=17) or topical calcineurin inhibitors (CI, n=11) between 2014-2022. Median time to clinical improvement was similar between groups (CS: 19 days vs CI: 16 days, p>0.10). However, disease control at final follow-up (median 91 days) was significantly more common with CS treatment (88% vs 55%, p<0.05). CS-treated cats achieved disease control with once-daily or less frequent dosing in 80% of cases compared to only 33% of CI-treated cats (p<0.05). Corneal ulceration was highly prevalent in both groups (CS: 71%, CI: 91%) but healed regardless of treatment modality. Acute bullous keratopathy developed in one cat from each treatment group. While initial response to treatment was comparable, topical corticosteroids appeared superior for long-term disease management and required less frequent administration, suggesting CS may be preferred first-line therapy for feline EK.

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