Diagnosis and management of allergic conjunctivitis in pediatric patients

Berger, William; Granet, David B.; Kabat, Alan G.

doi:10.2500/aap.2017.38.4003

Cited by 22 publications

(18 citation statements)

References 22 publications

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“…70,71 Medications Topical therapies for ocular allergy are outlined in Table 5, Table 6 and Table 7. [70][71][72][73][74][75][76][77][78][79][80][81]…”

Section: Avoidance and Nonpharmacologic Measuresmentioning

confidence: 99%

The spectrum of allergic ocular diseases

Rodrigues

Kuruvilla

Vanijcharoenkarn

et al. 2021

Annals of Allergy, Asthma & Immunology

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Ocular allergy is recognized as a heterogeneous collection of immunoglobulin E (IgE) and noneIgE-mediated diseases. IgE-mediated ocular allergies include seasonal allergic conjunctivitis, perennial allergic conjunctivitis, 1 vernal keratoconjunctivitis, and atopic keratoconjunctivitis. NoneIgE-mediated ocular allergies and hypersensitivities include contact blepharoconjunctivitis, giant papillary conjunctivitis, irritative conjunctivitis, and blepharitis.The following 4 cardinal symptoms characterize ocular allergies: redness, itchiness, swelling, and watering (tearing), with several symptoms overlapping with dry eye disease.Allergological workup (skin prick testing, serum-specific IgE measurements, conjunctival provocation testing, and patch testing) is helpful in confirming a causative allergic mechanism.Newer topical corticosteroid formulations such as loteprednol have not been found to increase the risk of cataracts unlike older corticosteroids.Successful treatment usually involves a combination of avoidance of allergic triggers, medications (topical, oral, or both), and in some cases, allergy immunotherapy.

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“…70,71 Medications Topical therapies for ocular allergy are outlined in Table 5, Table 6 and Table 7. [70][71][72][73][74][75][76][77][78][79][80][81]…”

Section: Avoidance and Nonpharmacologic Measuresmentioning

confidence: 99%

The spectrum of allergic ocular diseases

Rodrigues

Kuruvilla

Vanijcharoenkarn

et al. 2021

Annals of Allergy, Asthma & Immunology

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“…Although one of the most common ocular disorders in pediatric patients, AC is frequently overlooked, misdiagnosed, and undertreated in children. There is a paucity of best practice guidelines for the treatment of paediatric AC [25]. …”

Section: Managementmentioning

confidence: 99%

Allergic conjunctivitis in Asia

Thong

2017

Asia Pacific Allergy

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Allergic conjunctivitis (AC), which may be acute or chronic, is associated with rhinitis in 30%–70% of affected individuals, hence the term allergic rhinoconjunctivitis (AR/C). Seasonal and perennial AC is generally milder than the more chronic and persistent atopic and vernal keratoconjunctivitis. Natural allergens like house dust mites (HDM), temperate and subtropical grass and tree pollen are important triggers that drive allergic inflammation in AC in the Asia-Pacific region. Climate change, environmental tobacco smoke, pollutants derived from fuel combustion, Asian dust storms originating from central/north Asia and phthalates may also exacerbate AR/C. The Allergies in Asia Pacific study and International Study of Asthma and Allergies in Childhood provide epidemiological data on regional differences in AR/C within the region. AC significantly impacts the quality of life of both children and adults, and these can be measured by validated quality of life questionnaires on AR/C. Management guidelines for AC involve a stepped approach depending on the severity of disease, similar to that for allergic rhinitis and asthma. Topical calcineurin inhibitors are effective in certain types of persistent AC, and sublingual immunotherapy is emerging as an effective treatment option in AR/C to grass pollen and HDM. Translational research predominantly from Japan and Korea involving animal models are important for the potential development of targeted pharmacotherapies for AC.

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“…27 The pharmacological treatment include variety of currently available drugs to treat VKC that include antihistamines, mast-cell stabilizers, dual acting agents, corticosteroids and immunomodulators. 25,28 A new generation of drugs such as bepotastine, olopatadine, epinastine, ketotifen and azelastine has shown dual activity of mast-cell stability and H1 receptor antagonism makes them suitable for twice-daily dosing. 25 Besides these action they also exert anti-inflammatory effects through several different mechanisms.…”

Section: Introductionmentioning

confidence: 99%

Comparative evaluation of efficacy and safety of bepotastine besilate 1.5% ophthalmic solution versus olopatadine hydrochloride 0.1% ophthalmic solution in patients with vernal keratoconjunctivitis

Gupta¹,

S²,

Rewri³

2021

Int J Basic Clin Pharmacol

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Background: Vernal keratoconjunctivitis (VKC) is a chronic, seasonally exacerbated, allergic ocular inflammation. It affect children and young adults and has male predominance. The first line of treatment often used is dual acting drugs like olopatadine and bepotastine. It combine the immediate histamine receptor antagonism, coupled with mast cell stabilization with other anti-inflammatory properties. The present study was conducted to compare the efficacy and safety of olopatadine 0.1% and bepotastine 1.5% eye drops in VKC patients.Methods: This was a prospective, open label, randomized and comparative clinical study conducted for 21 days. 65 patients of VKC of 5-15 years of either sex were randomized in two study arm. Arm A, given bepotastine 1.5% and arm B, given olopatadine 0.1% twice daily for 21 days. Symptoms and signs scoring of VKC along with safety assessment were recorded on baseline and at time of follow up on 7th day and 21st day.Results: After 3 weeks of drug therapy, patients in both arms showed improvement in the symptoms and signs scoring of VKC. There was no statistically significant difference between the two treatment arms. However, improvement in clinical parameters particularly ocular itching, which is the main complaint of patients with VKC was more in bepotastine arm as compared to olopatadine treated arm. Both the drugs were well tolerated without any serious adverse effect.Conclusions: Both olopatadine and bepotastine were found to be effective in alleviating the clinical symptoms and signs of VKC. However, bepotastine performed better in reducing ocular itch than olopatadine.

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Diagnosis and management of allergic conjunctivitis in pediatric patients

Abstract: The diagnostic and treatment algorithms and guidelines provided in this review help address the current literature and educational gap and may lead to improvements in diagnosis and management of pediatric AC.

Cited by 22 publications

References 22 publications

The spectrum of allergic ocular diseases

The spectrum of allergic ocular diseases

Allergic conjunctivitis in Asia

Comparative evaluation of efficacy and safety of bepotastine besilate 1.5% ophthalmic solution versus olopatadine hydrochloride 0.1% ophthalmic solution in patients with vernal keratoconjunctivitis

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