Ocular allergy latin american consensus

Abstract

Study carried out at the Primeira parte (Questionários): online. Segunda parte (Meeting): OrlandoMiami, USA. Terceira Parte (Análise Estatística): São Paulo (SP), Brazil. ABSTRACTPurpose: To establish current definition, classification and staging, and to develop diagnosis and treatment recommendations for ocular allergy, by using Delphi approach. Methods: Ten Latin American experts on ocular allergy participated in a 4-round Delphi panel approach. Four surveys were constructed and answered by panelists. A two-thirds majority was defined as consensus. Definition, classification, staging and diagnosis and treatment recommendations were the main outcomes.Results: "Ocular allergy" was proposed as the general term to describe ocular allergic diseases. Consensus regarding classification was not reached. Signs and symptoms were considered extremely important for the diagnosis. It was consensus that a staging system should be proposed based on the disease severity. Environmental control, avoidance of allergens and the use of artificial tears were recommended as first line treatment. The secondary treatment should include topical anti-histamines, mast cell stabilizers and multi actions drugs. Topical non-steroidal anti-inflammatory and vasoconstrictors were not recommended. Topical corticosteroids were recommended as third line of treatment for the most severe keratoconjunctivitis. Consensus was not reached regarding the use of systemic corticosteroids or immunosuppressant. Surgical approach and unconventional treatments were not recommended as routine. Conclusion:The task of creating guidelines for ocular allergies showed to be very complex. Many controversial topics remain unsolved. A larger consensus including experts from different groups around the world may be needed to further improve the current recommendations for several aspects of ocular allergy.

Global Consensus on Keratoconus and Ectatic Diseases

“…32,36,38 Before this project, we undertook a successful pilot of this specific consensus with Latin-American corneal specialists as a test-run that was approved by the 4 cornea societies. 45 One of the advantages of the Delphi method is that information can be gathered from a geographically diverse panel of participants while keeping their anonymity, which reduces the halo effects associated with the opinions of prominent participants.…”

“…One adaptation to this method was to include a face-to-face meeting to address unresolved issues after the initial question rounds (round 3) with a final presentation and approval by all panelists together (designated as Delphi +1). 32,38,39 Each of the 4 supranational corneal societies, the Asia Cornea Society (Asia), Cornea Society (USA and international), EuCornea (Europe), and PanCornea (Latin America, the United States, and Canada), assigned 2 coordinators for the project (Asia assigned 1 additional coordinator-a total of 9 coordinators). These coordinators are accomplished cornea specialists with previous experience in the design, conduct, and publication of expert panels.…”

“…[29][30][31] In ophthalmology, the Delphi method has been used for establishing consensus on dry eye, 32 cataract surgery, 33 primary open-angle glaucoma, 34 thyroid eye disease, 35 infection prophylaxis, 36 age-related macular degeneration, 37 and ocular allergy. 38 The current work presents a consensus regarding the management of keratoconus and other ectatic conditions from a panel of ophthalmology experts from around the world using a modified Delphi method. The consensus covers the most relevant and contentious questions regarding the definition, methods of diagnosis, and the nonsurgical and surgical treatments of these diseases.…”

Correlations Between Allergen-Specific IgE Serum Levels in Patients With Ocular Allergy

“…5 Seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), vernal keratoconjunctivitis (VKC), and atopic keratoconjunctivitis (AKC) are the ocular allergic disorders most frequently classified as "allergic conjunctivitis." [6][7][8] Despite their pathophysiological differences, some authors also include other types of allergy-related reactions, such as giant papillary conjunctivitis, as part of this disease group. [8][9][10] Allergic conjunctivitis is clinically diagnosed after a medical examination, including biomicroscopy directed to the eyelids, bulbar and tarsal conjunctivas, limbus, and cornea.…”

Allergic conjunctivitis in Asia

“…Several practice guidelines on the management of AC have been published including those from Europe [3], Latin America [20], Japan [21] and Spain [22]. Principles of management include [2324]:…”