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Rasmussen MLR, D'Souza M, Topal DG, Gradman J, Larsen DA, Lehrmann BB, Kjaer HF, Kessel L, Subhi Y. Prevalence of allergic sensitization with vernal keratoconjunctivitis: A systematic review with meta-analyses. Acta Ophthalmol 2023; 101:9-21. [PMID: 35848379 PMCID: PMC10084059 DOI: 10.1111/aos.15212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/29/2022] [Accepted: 06/21/2022] [Indexed: 01/25/2023]
Abstract
To determine the prevalence of allergic sensitization in patients with vernal keratoconjunctivitis (VKC) and to provide an overview of published studies on this topic. We systematically searched 11 literature databases on 24 May 2021, for studies with cross-sectional data on the prevalence of positive allergy tests in patients with VKC. Our main outcome of interest was the prevalence of allergic sensitization and the allergens involved. Prevalence meta-analyses were made to provide summary estimates. We identified 33 eligible studies for qualitative review with 2122 patients with VKC. Studies were predominantly based on patients seen in ophthalmology clinics. Overall, studies reported that the most prevalent positive allergen tests were the inhaled allergens house dust mites and pollen. Twenty-nine studies were eligible for the quantitative analysis. Here, we calculated the prevalence of allergen-positive patients to 57.7% (95% confidence interval: 52.5%-62.8%). Subgroup analyses of pooled estimates on sensitization based on specific testing methods found prevalence estimates of 51.4% for conjunctival provocation test, 68.7% for total tear IgE, 58.9% for specific tear IgE, and 58.2% for skin prick test. The prevalence of allergic sensitization in patients with VKC is 57.7%, and mostly towards inhaled allergens. The most frequent positive allergens are house dust mites and pollen. Identifying possible clinically relevant allergens provide information that may aid in managing VKC, such as environmental allergy-avoidance or allergy-specific treatment.
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Affiliation(s)
- Marie Louise Roed Rasmussen
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Maria D'Souza
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark
| | | | - Josefine Gradman
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | | | | | | | - Line Kessel
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Yousif Subhi
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Sayed KM, Ali AH. IgE Mediated Wheat Allergy Associated with Resistant and Severe Forms of Allergic Conjunctivitis. Open Respir Med J 2022. [DOI: 10.2174/18743064-v16-e2208170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective:
This study aimed to determine the prevalence and criteria of wheat allergy (WA) among patients with resistant allergic conjunctivitis (AC).
Methods:
A prospective comparative study was conducted on 100 patients with resistant AC. Skin prick-tests (SPTs), total and sIgE against a panel of inhalant and food allergens were performed in all patients’ sera. They were divided into 2 groups according to skin prick test (SPT) and specific IgE (sIgE) level, namely the wheat sensitive group (WSG) and wheat tolerant group (WTG). Total ocular symptom scores (TOSS) and 4-point sign scales were correlated for both groups.
Results:
Ten patients out of 100 with IgE-mediated resistant AC were wheat sensitive, and the other 90 were wheat tolerant patients. WSG included patients of significantly younger age. Positive family history of atopy was proven in 100% of WSG vs. 67% of WTG. A significantly higher frequency of multiorgan allergy was detected in 100% of WSG vs. 20% in WTG (P = 0.0001). Thirty (30%) of WSG had associated allergic rhinitis (AR) and bronchial asthma (BA). Another 30% had an associated AR only, 10% had an associated BA only, and another 20% had an associated skin allergy. TOSS, 4- point sign scale, and total IgE level were significantly higher in WSG.
Conclusion:
This study provides novel evidence that wheat allergy is responsible for some severe forms of AC.
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Ghiglioni DG, Bruschi G, Milani GP, Marchisio PG. Vernal allergic march. Pediatr Allergy Immunol 2021; 32:1093-1095. [PMID: 33615542 DOI: 10.1111/pai.13483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/14/2021] [Accepted: 02/18/2021] [Indexed: 11/28/2022]
Affiliation(s)
| | - Gaia Bruschi
- Università degli Studi di Milano, Department of Pathophysiology and Transplantation, Milan, Italy
| | - Gregorio P Milani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,University of Milan, Department of Clinical Science and Community Health, Milan, Italy
| | - Paola G Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Università degli Studi di Milano, Department of Pathophysiology and Transplantation, Milan, Italy
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Palmares J, Delgado L, Cidade M, Quadrado MJ, Filipe HP. Allergic Conjunctivitis: A National Cross-Sectional Study of Clinical Characteristics and Quality of Life. Eur J Ophthalmol 2018; 20:257-64. [DOI: 10.1177/112067211002000201] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Luis Delgado
- Immunology Department, Faculty of Medicine, Universidade do Porto, Porto
| | | | - Maria J. Quadrado
- Ophthalmology Department, Hospitals da Universidade de Coimbra, Coimbra
| | - Helena P. Filipe
- Ophthalmology Department, Instituto Gama Pinto, Lisboa - Portugal
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Mantelli F, Calder VL, Bonini S. The Anti-Inflammatory Effects of Therapies for Ocular Allergy. J Ocul Pharmacol Ther 2013; 29:786-93. [DOI: 10.1089/jop.2013.0161] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - Stefano Bonini
- Department of Ophthalmology, Campus Bio-Medico University of Rome, Rome, Italy
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Bozkurt B, Artac H, Arslan N, Gokturk B, Bozkurt MK, Reisli I, Irkec M. Systemic Atopy and Immunoglobulin Deficiency in Turkish Patients with Vernal Keratoconjunctivitis. Ocul Immunol Inflamm 2013; 21:28-33. [DOI: 10.3109/09273948.2012.723110] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Turan-Vural, E, Acar BT, Acar S. The Efficacy of Topical Interferon Alpha 2b Treatment in Refractory Vernal Keratoconjunctivitis. Ocul Immunol Inflamm 2012; 20:125-9. [DOI: 10.3109/09273948.2012.656877] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Smedt SD, Nkurikiye J, Fonteyne Y, Hogewoning A, Esbroeck MV, Bacquer DD, Tuft S, Gilbert C, Delanghe J, Kestelyn P. Vernal keratoconjunctivitis in school children in Rwanda and its association with socio-economic status: a population-based survey. Am J Trop Med Hyg 2011; 85:711-7. [PMID: 21976577 PMCID: PMC3183782 DOI: 10.4269/ajtmh.2011.11-0291] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Accepted: 07/13/2011] [Indexed: 11/07/2022] Open
Abstract
Vernal keratoconjunctivitis (VKC) is an allergic eye disease and an important cause of hospital referral among children in Africa and Asia. Hospital-based studies have suggested a role for parasites in its pathogenesis. To determine the prevalence and risk factors for VKC in Central Africa, we conducted a nested population-based case control study in Rwanda, involving randomly selected primary schools from different environments (rural/urban) and climate. A prevalence of VKC of 4.0% (95% confidence interval 3.3-4.7%) was found among 3,041 children studied (participation rate 94.7%). The intestinal parasitic burden was not related to VKC. Besides hot dry climate (odds ratio [OR] = 1.5, P = 0.05) and male gender (OR = 1.7, P = 0.005), multivariate analysis identified higher economic status as a risk for VKC (OR = 1.4, P = 0.005). The effect on VKC of higher economic status appears not to act through differences in parasitic intestinal load.
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Affiliation(s)
- Stefan De Smedt
- Ophthalmology Department, Kabgayi Hospital, Muhanga, Rwanda.
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A simple and rapid diagnostic algorithm for the detection of ocular allergic diseases. Curr Opin Allergy Clin Immunol 2009; 9:471-6. [DOI: 10.1097/aci.0b013e3283303ea2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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