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PubMedDate not supplied

[Skin reactivity in allergic conjunctivitis].

Allergic conjunctivitis is a very common disease in our country. We intend to determine the most frequent ocular involvement and the specific sensitivity to common aeroallergens. A longitudinal prospective study was performed on 20 patients from the allergy/immunology and ophthalmology outpatient service, Hospital Infantil de Mexico Federico Gomez, from May to July 1990. All of them had allergic conjunctivitis and were evaluated for ocular involvement and reactivity to common aeroallergens by skin prick test.

Adolescent↗
PubMed1986

Perennial allergic conjunctivitis: definition, clinical characteristics and prevalence. A comparison with seasonal allergic conjunctivitis.

Perennial allergic conjunctivitis (PAC) is a perennial form of seasonal allergic (hay fever) conjunctivitis (SAC). Fourteen subjects with PAC were compared with 25 subjects with SAC. All patients met the same criteria for the diagnosis of a Type 1 ocular allergy. In a study of ophthalmic morbidity at an inner city health centre during the summer months the 3-month period prevalence of PAC was 3.5:10,000. In PAC symptoms are present throughout the year although seasonal exacerbations occurred in 79 per cent. Many similarities were found with SAC. PAC showed the same age range, length of history and symptoms as SAC although SAC was more severe. In both, conjunctival cytology showed eosinophils (PAC 43 per cent; SAC 25 per cent) and total IgE levels were raised in the tears (PAC 100 per cent; SAC 96 per cent) and serum (PAC 79 per cent; SAC 78 per cent). However, PAC differed from SAC in several respects: a history of exacerbation on exposure to house dust (PAC 42 per cent; SAC none) and an association with perennial rhinitis (PAC 75 per cent; SAC 12 per cent) were more common in PAC. The largest response on skin prick testing to a panel of antigens was to house dust mite (Dermatophagoides pteronyssinus) and this was more frequent in PAC (PAC 71 per cent; SAC 4 per cent). Dust mite antigen specific IgE was present in the tears of 78 per cent of cases of PAC, in higher levels than in serum indicating local production of IgE, whereas in SAC there were no detectable levels in any of the tears tested.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Immunotherapy in allergic conjunctivitis.

Eighty patients with allergic conjunctivitis were treated with immunotherapy employing specific allergens. Sixty-two percent of these showed beneficial response. In cases of vernal conjunctivitis needing topical steroid preparations frequently for control of symptoms, immunotherapy is worth attempting to cause remission of symptoms.

Adolescent↗
PubMed1985

A double-blind evaluation of topical levocabastine, a new specific H1 antagonist in patients with allergic conjunctivitis.

Forty patients suffering from allergic conjunctivitis, due to birch pollen, participated in a double-blind parallel group comparison between levocabastine (a potent new specific histamine (H1) antagonist) and placebo, both given as eye drops. Symptom scores were recorded during a 4-week period. A 1-week run-in period was followed by a 3-week treatment period. To enable a fair evaluation of the treatment effect on the ocular symptoms only, all patients were treated with topical nasal glucocorticoids for possible rhinitis symptoms during the whole study period. Plasma levels of levocabastine were determined in all subjects at the end of the 3 weeks' treatment period. Pollen counts for birch pollen were followed simultaneously. The evaluation of the symptom score cards revealed a significant reduction of ocular symptoms following use of the active compound. The resorption of the active substance through the conjunctiva was low. In accordance with the present trend of more topical treatment for allergic rhinitis, levocabastine may constitute a valuable compound for the topical treatment of allergic conjunctivitis.

Adolescent↗
PubMed1992

Drug treatment of allergic conjunctivitis. A review of the evidence.

Allergic conjunctivitis, unlike several other ocular diseases, is seldom followed by permanent visual impairment; nevertheless, it is important because of both its frequency and its severity. Two major forms, seasonal and perennial, are considered in this review. To recognise the hallmarks of allergic conjunctivitis, clinicians have need of a thorough knowledge of its pathophysiological aspects and clinical features, enabling them to choose the best and most suitable therapy among the alternatives. The aims of treatment vary according to the symptoms, severity and characteristics of the allergic reactions; in general, treatment is based mainly on environmental control, pharmacotherapy and (sometimes) specific immunotherapy. Topical vasoconstrictors, decongestant compounds, standard antihistamines or combinations of these drugs have been used for a number of years to treat the acute and/or persistent symptomatology, and in order to prevent the side effects of a prolonged treatment with topical glucocorticosteroids. Nevertheless, the latter represent the most powerful anti-inflammatory drugs, and are particularly recommended in short term treatment (5 to 7 days) in severe acute symptomatology. Orally administered 'classic' antihistamines, i.e. histamine H1-receptor antagonists, are effective and very convenient in either short or long term treatment, largely because the new compounds also act on the inflammatory process secondary to the allergic events. Recently, other topical compounds such as sodium cromoglycate (cromolyn sodium), nedocromil and nonsteroidal anti-inflammatory drugs (NSAIDs) [i.e. piroxicam, aspirin] have become available. Sodium cromoglycate and nedocromil act as prophylactic compounds, able to prevent the allergic reaction; NSAIDs represent a valid and effective alternative to glucocorticosteroids in several situations.

Conjunctivitis, Allergic↗
PubMed1992

[Allergic conjunctivitis].

The eye reacts to foreign substances through a variety of specific and non-specific defense mechanisms. Constantly exposed to a great variety of microorganisms, the eye is capable of protecting itself without altering its own structure and function. Its resistance relies upon anatomic and physiological properties of its external components (eyelids, tears, conjunctiva and cornea). Most of the times, the conjunctiva becomes affected, resulting in a clinical picture of conjunctivitis where allergy predominates, expressed as allergic rhinoconjunctivitis, allergic conjunctivitis, vernal keratoconjunctivitis, giant papillary conjunctivitis and flictenular conjunctivitis. The physiopathology is considered to be of type I reaction (IgE mediated). Frequent complains often associated with other allergic diseases are: pruritus, tearing, photofobia and ocular redness. The diagnosis of allergic conjunctivitis in done by means of a throughout clinical history, conjunctival citology and evaluation of specific IgE with immediate skin tests. Treatment is symptomatic (antihistamines, antibiotics and/or topic steroids), but prevention (environmental control and sodium cromoglycate) and specific immunotherapy must be considered.

Conjunctivitis, Allergic↗
PubMed1979

[The allergic conjunctivitis (author's transl)].

The authors report the study of 51 cases of conjunctivitis which the allergic character has been showed. They emphasize: 1. the special frequency with the young person (between 20 and 30 years for allergic conjunctivitis, generally before 7 years for vernal conjunctivitis); 2. the importance of atopic ground; 3. the weak incidence of business; 4. the difficulty of diagnosis, because the monosensibilisations are uncommon; 5. the favourable result of treatment.

Adult↗
PubMed1987

The ability of salbutamol and theophylline to suppress immediate allergic conjunctivitis in the guinea pig.

Topically administered salbutamol was extremely effective in suppressing immediate allergic conjunctivitis in the guinea pig; a dose as low as 0.1% elicited 98% inhibition. Topical pretreatment with 1% propranolol completely blocked the suppressant action of 0.1% salbutamol. This was also the case after systemic propranolol (1 mg/kg SC); the beta-adrenoceptor antagonist itself has no effect on antigen-induced inflammation. The effect of 0.1% salbutamol was unaltered by pretreatment with the specific beta 1-adrenoceptor antagonist betaxolol (1 mg/kg SC). In marked contrast, the suppressant action of 0.1% salbutamol was profoundly inhibited by pretreatment with the selective beta 2-adrenoceptor antagonist ICI-118,551 (0.5 mg/kg SC). The experiments employing beta-adrenoceptor antagonists unequivocally demonstrate that the salbutamol suppression of immediate allergic conjunctivitis in the guinea pig is mediated via the activation of beta 2-adrenoceptors. The methylxanthine phosphodiesterase inhibitor theophylline was active after oral administration, 50 mg/kg eliciting an 80% inhibition. Theophylline was inactive topically at 1% and 5%, but this could be due to the fact that the compound was insoluble at these concentrations. Thus, procedures that elevate cyclic-AMP levels suppress immediate hypersensitivity reactions in the guinea pig conjunctiva. Whether or nor this offers an alternative approach to treat allergic conjunctivitis in humans remains to be determined.

Administration, Oral↗
PubMed1977

[A study in immunofluorescence of the plasma cells in allergic conjunctivitis, in particular of the cells forming immunoglobulin E (IgE) (author's transl)].

The relatively simple and precise technique of direct immunofluorescence on a tissue section enables the study and enumeration of all types of plasma cells including mastocytes (stained with acridine orange) in normal conjunctiva (5 cases), chronic non-allergic conjunctivitis (5 cases), allergic conjunctivitis of the educt (11 cases) and vernal conjunctivitis (11 cases). There is evidence of elevation of IgE plasma cells in type I allergic conjunctivitis where they are twice as raised as in non-allergic cases in adult forms, and three times more elevated in vernal conjunctivitis. There was no correlation between the number of IgE plasma cells in the tissues and IgE level in sera. Thus in air-borne conjunctival allergies local hypersensitivity seems to be the predominant, even exclusive, feature.

Adult↗
PubMed1992

Efficacy and safety of nedocromil sodium ophthalmic solution in the treatment of seasonal allergic conjunctivitis.

To assess the efficacy and safety of twice-daily administration of nedocromil sodium 2% ophthalmic solution, we performed a multicenter study involving 140 patients with seasonal allergic conjunctivitis. Subjects had a history of seasonal allergic conjunctivitis and positive results of a skin test to ragweed. The trial coincided with the peak ragweed pollen season at five treatment centers. Patients treated with nedocromil sodium had improvements in symptoms with statistically significant reductions recorded for eye itching (P less than or equal to .04), conjunctival injection (P less than or equal to .001), and overall disease severity (P less than or equal to .001) as compared to the placebo-treated group. Adverse events were minor and transient. We concluded that nedocromil sodium 2% ophthalmic solution administered twice daily is effective in relieving major symptoms associated with seasonal allergic conjunctivitis.

Adolescent↗
PubMed1990

Effects of Vasocon-A in the allergen challenge model of acute allergic conjunctivitis.

The ophthalmic combination product of 0.05% naphazoline hydrochloride and 0.5% antazoline phosphate (Vasocon-A) was evaluated as an antiallergic agent in 100 subjects with a known allergic history to cat dander, ragweed, or bluegrass pollen. Three independent study sites were used. The allergen challenge model of acute allergic conjunctivitis was selected to assess the agent as it provided a standardized and precise way to measure drug effectiveness for this indication. In a double-masked randomized fashion, the subjects were assigned to one of three groups that received one drop of Vasocon-A in one eye and one drop of either 0.05% naphazoline (group 1), 0.5% antazoline (group 2), or placebo (group 3) in the contralateral eye. After 10 minutes, the dose of allergen shown to elicit a 2+ redness and itching reaction was instilled bilaterally. Signs and symptoms of allergic conjunctivitis were evaluated after 3, 5, and 10 minutes. Subjects were then rechallenged 2 hours after drug administration to assess the duration of action of the agents. Vasocon-A was found to significantly inhibit all five major signs and symptoms of allergic conjunctivitis: itching, redness, chemosis, lid swelling, and tearing, for more than 85% of the comparisons when compared over time with placebo, naphazoline alone, or antazoline alone. The results of this study indicate that the combination of naphazoline and antazoline was more effective in inhibiting redness than naphazoline and more effective in inhibiting itching than antazoline. These findings support the use of such a combination for the treatment of allergic conjunctivitis.

Allergens↗
PubMedDate not supplied

Cytology of allergic conjunctivitis. Presence of airborne, nonhuman elements.

Two groups of patients suffering from allergic conjunctivitis (32 atopic, 33 nonatopic) were studied. Their conjunctival secretions were subjected to cytologic examination involving morphologic and semiquantitative evaluation. Account was taken of noncellular and nonhuman elements in the smears; they included mucus, Charcot-Layden crystals, pollen grains, vegetal fragments and fungi. In 12 cases scanning electron microscopy was used in conjunction with x-ray microanalysis to identify material of noncellular origin. Similar quantities of inflammatory cells were present in both groups, while epithelial cells, particularly goblet cells, were more numerous in the atopic than in the nonatopic group (21.8% versus 6%). Pollen grains, vegetal fragments and fungi were present in 18%, 55% and 12% of cases, respectively. Exfoliative cytology emerges as a valuable tool for the diagnosis of allergic conjunctivitis, while the presence of noncellular elements is of particular diagnostic significance.

Adolescent↗
PubMed1991

Double-blind trial of pentigetide ophthalmic solution, 0.5%, compared with cromolyn sodium, 4%, ophthalmic solution for allergic conjunctivitis.

Fifty patients (25 per group) with the signs and symptoms of allergic conjunctivitis confirmed by positive skin test enrolled in this randomized, double-blind, parallel group, 2-week comparison of pentigetide, 0.5%, ophthalmic solution (Pentyde) and cromolyn sodium, 4%, USP ophthalmic solution (Opticrom). The physician and the patient rated the patient's overall ocular condition on days 3, 8, and 15. On day 15 both the physician and the patients rated the pentigetide group as significantly (Chi-square, P less than .05) more improved than the cromolyn sodium group. The physician rated independently conjunctival symptoms and ocular signs at days 1, 3, 8, and 15. Improvement in signs and symptoms favored pentigetide in the majority of comparisons to cromolyn sodium (14 of 18). The pentigetide group showed significantly (ANOVA, P less than .05) greater improvement in hyperemia, edema, lacrimation, and blurred vision/photophobia. Patients completed daily diaries for seven symptoms. At the end of the study, comparisons to baseline between groups favored the pentigetide group for six of the seven symptoms; for itching, improvement favored significantly (ANOVA, P less than .05) the pentigetide group. The mean severity of all symptoms decreased by 64% in the pentigetide group as compared with a decrease of 46% in the cromolyn sodium group. Adverse experiences were minor and comparable in both groups. No clinically abnormal changes were noted for visual acuity, intraocular pressure, or common laboratory tests. This double-blind, active-controlled trial demonstrates that pentigetide, 0.5%, ophthalmic solution is safe and effective in the treatment of allergic conjunctivitis.

Adolescent↗
PubMedDate not supplied

[Allergic conjunctivitis. Treatment and course].

A group of 74 patients with allergic conjunctivitis from the out patient service of allergy of the Hospital Pediátrico Provincial Docente José Luis Miranda, in Santa Clara, were studied. In this study are stressed the importance of the search for etiologic agents influencing the disease and the used diagnostic methods. Finally, the used treatments are pointed out. The most frequent were the strepto-staphylo-gamma vaccines, preventive measures, antibiotic drops, environmental measures and sodium cromoglycate drops. Treatment was dynamic, individual and associated with the ophthalmology and pediatric allergy specialties.

Child↗
PubMed1992

New trends in the treatment of allergic conjunctivitis.

Histamine is the key mediator producing itching, redness and chemosis in allergic conjunctivitis. Histamine levels in tears are increased ten-fold in patients with this allergic condition. Levocabastine is a newly synthesized histamine H1 antagonist which has been formulated as both eye drops and nasal spray. In well established assays of antihistamine activity, levocabastine was found to be the most potent antihistamine compound available, being 15,000 times more potent than chlorpheniramine. Ocular provocation studies in man have shown that levocabastine protects against the symptoms of allergen-induced conjunctivitis. Ophthalmological examinations, including slit lamp and ophthalmoscopy showed no adverse effects. Data from therapeutic studies are available for more than 1700 patients with allergic conjunctivitis treated for 2-16 weeks. One drop of levocabastine (0.5 mg/ml) per eye given two to four times daily provided significantly better symptom control than placebo, with good to excellent results in 71% of patients on levocabastine compared to 55% on placebo (p < 0.001). Levocabastine has a fast onset of action. In one study 94% of patients experienced symptom relief within 15 minutes after the first instillation. The effects observed with levocabastine were at least as good as those with ocular cromoglycate or oral terfenadine. The incidence of adverse experiences was not different from placebo. Levocabastine promises to be a valuable treatment for patients with allergic conjunctivitis.

Animals↗
PubMed1992

Twice daily 4% Sodium Cromoglycate vs. 2% Sodium Cromoglycate used four times daily in seasonal (grass pollen) allergic conjunctivitis.

It is well established that 2% Sodium Cromoglycate is an effective treatment for a number of allergic eye diseases. It has been shown to be non-toxic. It can be used longterm and in serious allergic problems it is a useful adjunctive therapy to steroids. The main problem with Sodium Cromoglycate is that the recommended dosage is a four times daily application and patient non-compliance is common. One of the main objectives of any therapy is to reduce the frequency of dosage and the current study has been designed to investigate the efficacy of a 4% solution of Sodium Cromoglycate, used twice daily, versus a 2% solution used four times daily in seasonal allergic conjunctivitis. A multicentre study, therefore, was carried out to assess the efficacy of both drugs and to assess any possibility of side effects. In addition, a unit dose was used, thus eliminating preservatives and it was used specifically in seasonal allergic conjunctivitis in the pollen season. This study showed that 4% Sodium Cromoglycate used twice daily was at least as affective as 2% Sodium Cromoglycate used four times daily.

Adolescent↗