Local specific immunotherapy in allergic conjunctivitis

Prete, Antonio; Loffredo, Christopher A.; Carderopoli, A.; Caparello, O.; Verde, Roberta; Sebastiani, Adolfo

doi:10.1111/j.1755-3768.1994.tb07192.x

Cited by 22 publications

(11 citation statements)

References 5 publications

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“…Del Prete et al [22] analyzed a group of 40 patients who suffered from seasonal allergic conjunctivitis triggered by different allergens ( Dermatophagoides , pollen and fungus). Half of the patients received eyedrops in both eyes as local ocular immunotherapy.…”

Section: Discussionmentioning

confidence: 99%

Digitally Analyzed Conjunctival Redness: Does Repeated Conjunctival Provocation Intrinsically Cause Local Desensitization of the Eye?

Gloistein

Astvatsatourov²,

Allekotte³

et al. 2015

Int Arch Allergy Immunol

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Background: Allergic reactions in patients with seasonal or perennial rhinoconjunctivitis mediated by airborne allergens can be effectively assessed with the conjunctival provocation test (CPT). The CPT is a fast and easy diagnostic procedure that challenges the ocular mucosa with instillations of allergen solutions into the conjunctival region. This paper aimed to investigate the possible influence of repeated diagnostic CPT procedures on the patient's clinical presentation, i.e. to analyze desensitization effects caused by diagnostic solutions and to show the reproducibility of CPT results. Methods: Treatment progress in 120 placebo-treated patients from 2 immunotherapeutic dose-finding studies was estimated and documented, as based on the CPT which was applied at 4 visits with intervals of 4, 8 and 16 weeks. High-resolution digital photos collected as part of the CPT documentation were analyzed by an external observer and by digital analysis software to determine conjunctival redness, completely independent of the subjectivity of investigators and patients. Results: Two extremal scenarios of the redness changes were considered after provocation with 10,000 standard quality units/ml. A maximal decrease of about 3% (t test: p = 0.0002; U test: p = 0.001) and a minimal decrease of about 1% (t test: p = 0.254; U test: p = 0.431) were found. Conclusions: The observed decrease in conjunctival hyperemia can be explained by local desensitization or by placebo effect. Due to the setup of both studies considered, we could not ascertain how these factors influence the decrease in redness. In order to attribute the observed effects to local conjunctival desensitization with certainty, further pilot studies are needed.

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Section: Discussionmentioning

confidence: 99%

Digitally Analyzed Conjunctival Redness: Does Repeated Conjunctival Provocation Intrinsically Cause Local Desensitization of the Eye?

Gloistein

Astvatsatourov²,

Allekotte³

et al. 2015

Int Arch Allergy Immunol

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“…Specimens were fixed and stained with May-Grumwald-Giemsa. 9 Antibiograms and antimicrograms were obtained to identify possible infection. Cultures were confirmed positive based on neutrophil count to avoid falsepositive results from contamination.…”

Section: Methodsmentioning

confidence: 99%

Allergic Conjunctivitis and Latent Infections

Forte

Cennamo

Prete

et al. 2009

Cornea

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“…Local immunotherapy by instillation to the ocular surface has also shown improvement in symptoms of AC, including significant reduction in cytological findings following 1 year of treatment [86].…”

Section: Immunotherapymentioning

confidence: 97%

Treatment of ocular allergies: nonpharmacologic, pharmacologic and immunotherapy

Bilkhu

Naroo

Wolffsohn³

2015

Expert Review of Ophthalmology

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Ocular allergy is a significant and growing issue worldwide but for many patients, it is often not differentiated from systemic conditions, such as hay fever. Management of seasonal and perennial allergic conjunctivitis is often poor. Management is principally through avoidance measures (blocking or hygiene), nonpharmaceutical (such as artificial tears and cold compresses) and pharmaceutical (such as topical antihistamines and prophylactic mast cell stabilizers). Vernal and atopic keratoconjunctivitis are more severe and generally need treatment with NSAIDs, steroids and immunomodulators. Giant papillary conjunctivitis can be related to allergy but also is often contact lens related and in such cases can be managed by a period of abstinence and replacement of the lens or a change in lens material and/or design. Immunotherapy can be efficacious in severe, persistent cases of contact lens or allergic conjunctivitis.KEYWORDS: antihistamine . atopic keratoconjunctivitis . giant papillary conjunctivitis . immunotherapy . mast cell stabilizer . ocular allergy . perennial allergic conjunctivitis . seasonal allergic conjunctivitis . vernal keratoconjunctivitis Allergic eye disease is the ocular manifestation of allergy, where the immune system produces an over-reaction or hypersensitivity to normally harmless substances known as allergens. The prevalence of allergy has shown a significant increase and appears to be plateauing across the world at a level between 15 and 20% [1,2]. Although genetics plays an important role in susceptibility, the increase in prevalence is suggested to be the result of improved hygiene practices and increased antibiotic use as a part of modern lifestyle and health care [3], in addition to environmental factors, such as increased air pollution, climate change and increased planting and importation of allergenic plant species [4,5]. Indeed, the effect of the environment is now considered a very strong influence on allergy prevalence; recent studies have shown that although migration to a new environment initially decreases prevalence in that area, it steadily increases to match that of the host country over time [6].Of those who suffer from allergy, approximately 15-20% experience a form of ocular response [7,8] and around 65% of those with rhinoconjunctivitis report ocular signs [9][10][11]. However, several authors have pointed out that ocular allergies may be underdiagnosed and undertreated, particularly seasonal allergic conjunctivitis (SAC), where the ocular symptoms may fall under the umbrella of seasonal hay fever, which may underestimate its true prevalence [9,12,13]. Ocular allergy encompasses a group of distinct clinical entities, typically confined to the conjunctiva, and includes allergic conjunctivitis (AC), which is subdivided into seasonal (SAC) and perennial forms (PAC), vernal keratoconjunctivitis (VKC), atopic keratoconjunctivitis (AKC) and giant papillary conjunctivitis (GPC) [12].Epidemiology AC is a classic Type I, IgE-mast cell-mediated hypersensitivity disorder and the m...

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Local specific immunotherapy in allergic conjunctivitis

Cited by 22 publications

References 5 publications

Digitally Analyzed Conjunctival Redness: Does Repeated Conjunctival Provocation Intrinsically Cause Local Desensitization of the Eye?

Digitally Analyzed Conjunctival Redness: Does Repeated Conjunctival Provocation Intrinsically Cause Local Desensitization of the Eye?

Allergic Conjunctivitis and Latent Infections

Treatment of ocular allergies: nonpharmacologic, pharmacologic and immunotherapy

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