Vernal keratoconjunctivitis treated with omalizumab: A case series

Occasi, Francesca; Duse, Marzia; Nebbioso, Marcella; Castro, Giovanna De; Fraia, Marco Di; Capata, Giulia; Lollobrigida, Valeria; Zicari, Anna Maria

doi:10.1111/pai.12737

Cited by 24 publications

(24 citation statements)

References 10 publications

(8 reference statements)

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“…Recent case reports have shown treatment of VKC with omalizumab: 4 patients who had failed topical therapy of both cyclosporine and tacrolimus showed improvement of ocular symptoms of itching and tearing, as well as ocular signs of hyperemia, and papillae. 31 There may also be a role for allergen-specific immunotherapy which avoids the side effects often seen with topical therapies. Patients with VKC often have hypersensitivity to pollens and house dust and have been shown to have improvement in signs and symptoms with subcutaneous allergen-specific immunotherapy (SCIT).…”

Section: Treatmentmentioning

confidence: 99%

Vernal keratoconjunctivitis

Addis¹,

Jeng²

2018

OPTH

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Vernal keratoconjunctivitis (VKC) is a chronic allergic conjunctivitis that is most often seen in young, males. Although most types of allergic conjunctivitis do not affect vision, VKC is unusual in that damage to the cornea from the condition can result in vision loss. Although it is typically seasonal, year-round symptoms can be seen, which can lead to uncertain diagnoses being made. Although the pathophysiology of VKC is better understood in recent years, allowing more targeted therapies, management of these patients can still be very challenging, and complications can occur. As such, aggressive management of VKC is necessary, especially since vision loss in the amblyogenic age range can be permanent.

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Section: Treatmentmentioning

confidence: 99%

Vernal keratoconjunctivitis

Addis¹,

Jeng²

2018

OPTH

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“…In this case, antihistamines, steroids and immunosuppressive drugs had failed to arrest the multiple flares and to effectively relieve symptoms. Omalizumab has been proposed as rescue therapy, and several reports have been published in recent years for the treatment of VKC [6][7][8][9][10][11][12][13]. Omalizumab has a mechanism of action that is beyond the simple blocking of IgE binding, so it may provide additional benefit by inhibiting the perpetuation of type 2 inflammation [14].…”

Section: Discussionmentioning

confidence: 99%

“…Although 1 of the 2 nonresponding patients was nonatopic, the lack of allergic sensitization would not seem to be the discriminating reason for a possible failure of therapy. Indeed, some authors [7,10,11] reported cases of patients with VKC, who were successfully treated with omalizumab, although they were not allergic. The anti-IgE monoclonal antibody omalizumab is a humanized IgG1 able to bind selectively free serum IgE, specifically in the Cε3 region of the Fc fragment.…”

Section: Discussionmentioning

confidence: 99%

“…Alternative therapies are immunosuppressive drugs, like cyclosporin A and tacrolimus, which usually are effective but may also cause adverse effects [5,6]. Recently, a few reports on the use of the anti-IgE monoclonal antibody omalizumab in severe VKC, for a total of 17 patients treated, showed encouraging results [6][7][8][9][10][11][12][13]. Currently, omalizumab has been licensed for use in severe allergic asthma and chronic spontaneous urticaria.…”

Section: Introductionmentioning

confidence: 99%

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Vernal Keratoconjunctivitis: A Case of Anti-IgE Treatment with Short-Lasting Remission

Gatta

Valle

Farinelli

et al. 2020

Case Rep Ophthalmol

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Vernal keratoconjunctivitis (VKC) is a persistent, severe allergic eye disease, mainly occurring in children, that can lead to severe ocular complications including visual loss. The underlying etiology and pathophysiology of VKC remain unclear. Common therapies include topical antihistamines and mast cell stabilizers that are effective in mild-to-moderate forms of VKC but are often ineffective in severe forms that require topical or systemic corticosteroids. Dependence on steroids is common with potential adverse effects both local, as increased intraocular pressure, glaucoma, infection and cataract, as well as systemic ones, as reduction in child growth velocity. Alternative therapies are immunosuppressive drugs, like cyclosporine A and tacrolimus, that usually are effective but may also cause adverse effects. A promising therapeutic option is omalizumab, a recombinant anti-IgE humanized monoclonal antibody, currently used as add-on therapy for moderate to severe uncontrolled allergic asthma and chronic spontaneous urticaria. Here, we report the short-time duration of effective relief of symptoms

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“…(4) Treatment can include antihistamines, mast cell stabilizers, corticosteroids, and omalizumab, the recently approved anti-IgE monoclonal antibody. (5,6) Various complications such as cataract and glaucoma can be seen in these patients due to the long-term use of corticosteroids. 7The aim of this study was to demonstrate the clinical features, severity of the disease, and demographics of patients with vernal keratoconjunctivitis presenting to our hospital, which serves the hottest and dryest areas of the country.…”

Section: Introductionmentioning

confidence: 99%

Demographic And Clinical Features Of Vernal Keratoconjunctivitis in a Hot Region: A Hospital-Based Study

Erdem¹

2019

Van Med J

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Objective: We aimed to evaluate the demographics and clinical features of patients with vernal keratoconjunctivitis who have presented to our hospital which serves the hottest and the driest climate region in our country and also the severity of the disease. Material and Methods: We retrospectively examined the examination findings of 143 patients diagnosed with vernal keratoconjunctivitis in the Bismil state hospital ophthalmology polyclinic between April 2018 and September 2018. Results: Of the patients included in the study, 106 (74.1%) were male and 37 (25.9%) were female with a mean age of 8.7 ± 3.9 (3-21) years. The disease most frequently affected patients aged 6-10 years (59 patients, 41.2%). Mixed type (81 patients, 56.6%) was the most common type, followed by limbal type (34 patients, 23.8%) and palpaberal type (28 patients, 19.6%). The most common symptoms were itching (100%), redness (70.6%), photophobia (57.3%) and watering (48.9%). The most common clinical findings included conjunctival congestion (67.8%), upper palpebral papilla (65.2%) and limbal papilla (40.5%). Mild severe type most commonly affected males (50 patients, 47.2%), while moderate type (62.2%) was seen more frequently in females. Only 7 patients (4.8%) had an allergic family history. Conclusions: Vernal keratoconjunctivitis is one of the main cause of ocular morbidity with different types of involvement and severity in our region especially in childhood. Hence, Patients with vernal keratoconjunctivitis should be monitored and treated during seasonal exacerbations to prevent possible complications of this disease especially in hot and dry areas such as our region.

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Vernal keratoconjunctivitis treated with omalizumab: A case series

Cited by 24 publications

References 10 publications

Vernal keratoconjunctivitis

Vernal keratoconjunctivitis

Vernal Keratoconjunctivitis: A Case of Anti-IgE Treatment with Short-Lasting Remission

Demographic And Clinical Features Of Vernal Keratoconjunctivitis in a Hot Region: A Hospital-Based Study

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