Abstract
Background
The clinical features of allergic ocular diseases (AOD) are characterized by their wide variety. Clinical evaluation criteria are essential not only for objective assessment in clinical trials, but also for clinical studies on etiological aspects of AOD. However, there have been no internationally established criteria for clinical evaluation and classification of the severity of AOD. We established new criteria and applied them to many cases of AOD, and evaluated their usefulness for clinical purposes. We also studied whether each clinical entity of AOD [allergic conjunctivitis (AC), atopic keratoconjunctivitis (AKC), and vernal keratoconjunctivitis (VKC)] can be distinguished by these criteria.
Methods
A prospective study was carried out to assess the differential diagnosis of 1079 patients with AOD (439 male and 640 female patients). Differential diagnosis of AC, AKC or VKC was made. These diseases were diagnosed and classified based on local and systemic clinical findings. Ten objective ocular clinical findings of conjunctival, limbal and corneal lesions were graded on a 4-point scale, and the total score, with a highest value of 30, was used as the clinical score.
Results
Among a total of 1079 cases, seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), AKC and VKC accounted for 876 (81.2%), 115 (10.6%), 47 (4.4%) and 41 (3.8%) respectively. The mean age in each disease was 52.9, 56.1, 25.7 and 16.6 years respectively. Total clinical score in SAC, PAC, AKC and VKC was 1.54, 2.13, 3.72 and 12.68 respectively. Both mean age and total clinical score in all combinations of two diseases showed significantly different results.
Conclusions
These results suggest that AOD can be classified by our new clinical grading system, and this system is sensitive enough for clinical evaluation of AOD. Re-evaluation of AOD is essential for constructing future strategies for the treatment of AOD, which are consists of various categories of ocular disorders.
Similar content being viewed by others
References
Belfort R, Marbeck P, Hsu CC, Freitas D (2000) Epidemiological study of 134 subjects with allergic conjunctivitis. Acta Ophthalmol Scand 78:38–40
Calonge M (1999) Classification of ocular atopic/allergic disorders and conditions: an unsolved problem. Acta Ophthalmol Scand 77:10–13
Ono SJ, Abelson MB (2005) Allergic conjunctivitis: Update on pathophysiology and prospects for future treatment. J Allergy Clin Immunol 115:118–122
Leonardi A, Borghesan F, Avarello A, Plebani M, Secchi AG (1997) Effect of lodoxamide and disodium cromoglycate on tear eosinophil cationic protein in vernal keratoconjunctivitis. Br J Ophthalmol 81:23–26
Brémond-Cignac D (2002) The clinical spectrum of ocular allergy. Curr Allergy Asthma Rep 2:321–324
Hanifin JM, Rajka G (1980) Diagnostic features of atopic dermatitis. Acta Dermatol Venereol 92(suppl):44–47
Bonini S (2004) Atopic keratoconjunctivitis. Allergy 59(suppl 78):71–73
Collum LM (1999) Vernal keratoconjunctivitis. Acta Ophthalmol Scand 77:14–16
Kosrirukvongs P, Vichyanond P, Wongsawad W (2003) Vernal keratoconjunctivitis in Thailand. Asian Pac J Allergy Immunol 21:25–30
Leonardi A, Cortivo R, Fregona I, Plebani M, Secchi AG, Abatangelo G (2003) Effects of Th2 cytokines on expression of collagen, MMP-1, and TIMP-1 in conjunctival fibrosis. Invest Ophthalmol Vis Sci 44:183–189
Acknowledgements
This work was supported by a Grant-in-Aid for Encouragement of Scientists (18591944) from the Ministry of Education, Science, Sports and Culture of Japan. We thank Dr. W. Gray for editing this manuscript.
Author information
Authors and Affiliations
Corresponding author
Additional information
The authors have no financial relationship with the organization that sponsored the research. The authors have full control of all primary data, and agree to allow Graefes Archive for Clinical and Experimental Ophthalmology to review their data upon request.
Rights and permissions
About this article
Cite this article
Uchio, E., Kimura, R., Migita, H. et al. Demographic aspects of allergic ocular diseases and evaluation of new criteria for clinical assessment of ocular allergy. Graefes Arch Clin Exp Ophthalmol 246, 291–296 (2008). https://doi.org/10.1007/s00417-007-0697-z
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-007-0697-z