Aguilar-Ángeles D, Lima-Gómez V, Rojo-Gutiérrez MI, Bermejo-Guevara MA, González-Ibarra M, López-Valladares KE

Language: Spanish
References: 26
Page: 13-17
PDF size: 64.38 Kb.

ABSTRACT

Background: Allergic etiology is suspected whenever a patient with conjunctivitis presents the typical clinical features; however, in ophthalmic practice, confirmation of the immune disease is uncommon. Ocular involvement is common in allergic rhinitis, and the current name of this entity is allergic rhinoconjunctivitis (ARC). Conjunctivitis diagnosis in ARC is inferred by the symptoms, but the most common ocular findings in patients with a confirmed allergic disease are unknown. The most common findings in allergic patients with ocular involvement were identified.
Methods:Anterior segment of patients with an ARC diagnosis offered by an immunologist were evaluated, and the rates of the most common (whether considered related to allergy or not) were determined; 95% confidence intervals (CI) for rates were calculated.
Results: One hundred and nineteen patients were evaluated, and the most common finding was conjunctival fornix edema (89.7%, 95% CI 83.5-94.7), followed by tarsal papillae (70.6%, 95% CI 62.4-78.8); the most common non-allergy-related finding was tear film deficiency (52.9%, 95% CI 43.9-61.9).
Conclusions: Conjunctival fornix edema was consistently more frequent than most of the signs used to diagnose allergic conjunctivitis in medical journals. It is suggested to intentionally look for this as recommended, in order to make a more easy diagnosis.

REFERENCES

1. Pavan-Langston D. Manual of ocular diagnosis and therapy. 5th ed. Philadelphia: Lippincott Williams & Wilkins;2002.

2. Apple DJ, Raab MF. Ocular Pathology. 5th ed. St Louis: Mosby;1998.

3. Johansson SGO, Bieber T, Dahl R et al. Revised nomenclature for allergy for global use: report of the Nomenclature Review Committee of the World Allergy Organization, October 2003. J Allergy Clin Immunol 2004;113:832-836.

4. Vázquez NF, Salas RE, Mogica MJD, Beltrán GFJ. Prevalencia y factores de riesgo para conjuntivitis alérgica en población infantil. Estudio comparativo efectuado en dos comunidades. Rev Alergia Mex 2002; 49:33-41.

5. Ono SJ, Abelson MB. Rhinitis, sinusitis and ocular diseases. Update review. J Allergy Clin Immunol 2005;115:118-122.

6. Vander JF, Gault JA. Ophthalmology secrets. 2nd ed. Philadelphia: Hanley and Belfus;2002.

7. Seamone C, Jackson WB. Immunology of the external eye. In: Tasman & Jaeger’s Duane’s Clinical Ophthalmology. 22nd ed. Philadelphia: Lippincott-Williams & Wilkins;1998. pp. 1-12.

8. Lombardo-Velásquez II, Juárez EJC, Ordaz-Favilla JC. Estudio comparativo de la eficacia clínica y seguridad de la rimexolona al 1% vs. el clorhidrato de olopatadina al 0.1% en pacientes pediátricos con conjuntivitis moderada a severa. Rev Mex Oftalmol 2004;78:22-25.

9. Gaytán-Melicoff JA, Baca-Lozada O, Velasco-Ramos R, Viggiano-Austria D. Comparación entre suero autólogo, clorhidrato de olopatadina y fumarato de ketotifeno, en el manejo de la conjuntivitis alérgica. Rev Mex Oftalmol 2005;79:25-31.

10. González JR, Baiza-Durán LM, Núñez-Adame RM, González-Cervantes CP. Estudio clínico comparativo de diclofenaco vs. ketorolaco en el manejo sintomático de las conjuntivitis alérgicas en niños. Rev Mex Oftalmol 2006;80:16-20.

11. Hingorani M, Calder V, Buckley RJ, Lightman SL. The role of conjunctival epithelial cells in chronic ocular allergic disease. Exp Eye Res 1998;67:491-500.

12. Calder VL, Jolly G, Hingorani M, et al. Cytokine production and mRNA expression by conjunctival T-cell lines in chronic allergic eye disease. Clin Exp Allergy 1999;29:1214-1222.

13. Metz DP, Hingorani M, Calder VL, Buckley RJ, Lightman SL. T-cell cytokines in chronic allergic eye disease. J Allergy Clin Immunol 1997; 100:817-824.

14. McGill JI, Holgate ST, Church MK, Anderson MF, Bacon A. Allergic eye disease mechanisms. Br J Ophthamol 1998;82:1203-1214.

15. Corneal/external disease panel. Conjunctivitis. Preferred Practice Patterns. San Francisco: American Academy of Ophthalmology; 2003.

16. Friedlander MH, Harris J, LaVallee N, Russell H, Shilstone J. Evaluation of the onset an duration of effect of Azelastine eye drops (0.05%) versus placebo in patients with allergic conjunctivitis using an allergen challenge model. Ophthalmology 2000;107:2152-2157.

17. Toribio P E. Conjuntivitis alérgica. Alergia. Asma e Inmunología Pediátricas 2001;10:15-19.

18. Campuzano AM, Juárez EJC, López PG, Penagos PMJ, Ordaz FJC. Alergenos y factores de riesgo en pacientes pediátricos con conjuntivitis alérgica estacional. Rev Alergia Mex 2002;49:105-111.

19. Singh AJ, Loch RSK Bradbury JA. Demographic study of paediatric allergic conjunctivitis within a multiethnic patient population. Br J Ophthalmol 2003;87:1195-1196.

20. Kidd M, McKenzie SH, Steven I, Lanz R. Efficacy and safety of ketotifen eye drops in the treatment of seasonal allergic conjunctivitis. Br J Ophthalmol 2003;87:1206-1211.

21. Segura NMH, Parra RM, Espinosa LFD, Herrera SA, Sosa EE, Torres SAP. Enfermedades coexistentes en pacientes asmáticos alérgicos. Estudio de 100 casos. Rev Alergia Mex 2004;51:130-133.

22. Mortemousque B, Jacquet A, Richard C, Depont F, Colin J, Moore N. Randomised double masked trial comparing the efficacy and tolerance of 0.05% mequitazine eye drops versus 0.05% levocabastine and placebo in allergic conjunctivitis induced by a conjunctival provocation test with Dermatophagoides pteronyssinus. Br J Ophthalmol 2004;88:336-340.

23. Ramírez CN, del Río NBE, Pérez MJ. Eficacia de la mequitazina en el alivio de los síntomas de la rinoconjuntivitis alérgica en niños. Experiencia clínica documentada. Rev Alergia Mex 2005;52:221-225.

24. Phipatakanul W. Allergic rhinoconjunctivitis: epidemiology. Immunol Allergy Clin North Am 2005;25:263-281.

25. Butrus S. Ocular allergy: diagnosis and treatment. Ophthalmol Clin North Am 2005;18:485-492.

26. Bielory M. Allergic diseases of the eye. Med Clin North Am 2006;90:129-148.