Relation Between Total Tear IgE and Severity of Acute Seasonal Allergic Conjunctivitis

Purpose: Measurement of total tear immunoglobulin E (IgE) is useful for the diagnosis of allergic conjunctivitis, but it is still unknown whether measurement of total tear IgE is useful for assessment of the severity of allergic conjunctivitis. We evaluated the relation between the total IgE level in tears and objective signs of allergic conjunctivitis. Methods: A prospective, nonrandomized, and cross-sectional study was conducted in 84 patients with allergic conjunctivitis (allergic group) and 80 age- and sex-matched healthy control subjects (control group). The total tear IgE score was obtained with the Allerwatch(?) test (0, 1, and 2), and ten severity scores (0, 1, 2, 3) were determined for objective ocular findings of the palpebral and bulbar conjunctiva, as well as limbal and corneal lesions. Results: The scores for total tear IgE and each of the objective ocular findings were higher in the allergic group than in the control group (all p < 0.01). The total tear IgE score was correlated with the severity of each clinical feature of allergic conjunctivitis (p < 0.01), except for corneal epithelial damage in the allergic group. Multivariate analysis revealed that the severity of giant papillae was the most important indicator of the total tear IgE score (odds ratio = 1.33, p < 0.00001). Conclusion: The total tear IgE score was correlated with the scores for objective signs of allergic conjunctivitis. This rapid test for total IgE in tear fluid is easy to perform and could be used to assess the severity of allergic conjunctivitis on an outpatient basis.     

充分认识儿童过敏性结膜炎的干眼症问题

儿童过敏性结膜炎以春季角结膜炎为主。儿童过敏性结膜炎合并的干眼症的发生与泪膜稳定性降低有关。嗜酸性粒细胞活化、炎性因子释放以及结膜上皮细胞和杯状细胞受损、丢失，粘液层缺乏，导致泪膜稳定性下降及干眼症。此种干眼症的症状以瞬目次数增加为主，其次是眼痒、眼红和畏光。诊断儿童过敏性结膜炎时应考虑是否合并干眼症，给予恰当的处理可避免其引起的严重眼表损害。     

Correlation between tear IgE levels and HLA-DR expression by conjunctival cells in allergic and nonallergic chronic conjunctivitis

Background: Chronic conjunctival inflammatory diseases may depend upon various mechanisms. Discriminating allergy from nonspecific inflammation has become of striking importance for diagnosis and treatment. We investigated conjunctival inflammatory response by comparing two objective biological tools, tear IgE and HLA-DR expression by conjunctival epithelium, as indirect indicators of activation of the Th2 and Th1 subsets, respectiv-ely. Methods: Eighty-two patients with chronic conjunctivitis underwent tear IgE measurement by an ELISA technique and quantitation of HLA-DR expression in impression cytology specimens. Forty-two had direct or indirect clinical indications of allergic mechanisms, 26 had chronic conjunctivitis without any sign of allergy, and 14 suffered from isolated nonallergic dry eyes. Results: Patients clinically considered as allergic only showed positive IgE in 47 of 84 eyes (56%), whereas 21% and 25% of eyes with nonspecific conjunctivitis and dry eyes respectively were also positive. IgE levels were significantly higher in the allergic group than in the other two groups. HLA-DR positivity in epithelial cells was found in 28.5%, 48% and 50% of eyes, respectively. HLA-DR expression by epithelial cells was negatively correlated with tear IgE, as most specimens positive to one criterion were negative to the other one (49 eyes DR+, IgE–; 47 eyes DR–, IgE+; only 9 eyes positive to both criteria; chi-square: P=0.0001). Conclusion: As IgE synthesis and HLA-DR induction may represent indirect indicators of the activation of the Th2 and Th1 subsets, association of these two simple tests could be interesting for the routine assessment of the mechanisms of inflammatory ocular surface diseases. Received: 22 February 2000 Revised: 4 May 2000 Accepted: 16 May 2000     

Tear film lipid layer alterations in allergic conjunctivitis

PURPOSE: To assess the alterations of the tear film lipid layer and tear functions in patients with seasonal allergic conjunctivitis (SAC) and to compare the results with healthy control subjects. METHODS: Seventy-eight eyes of 39 consecutive patients diagnosed as SAC (mean age 32.6 years; 11 male, 28 female) as well as 20 eyes of 10 healthy control subjects (mean age 32.5 years; 6 male, 4 female) underwent slit-lamp examinations, tear film breakup time measurements (BUT), corneal fluorescein stain scoring, Schirmer test, and tear film lipid layer interferometry. The 2 groups were then compared for the examined parameters. RAST and serum IgE level evaluations were also carried out in the patients to confirm the diagnosis of allergy. RESULTS: The mean BUT was 3.4 +/- 1.5 seconds in patients with SAC compared with the mean value of 12.4 +/- 2.4 seconds in the controls (P < 0.05). There were no significant differences in relation to Schirmer test values between the 2 groups; 78% of the patients with SAC had grade 3 or above dry eye change in tear film lipid layer interferometry, whereas none of the controls had an interferometry grade greater than 3 (grade 1-2 normal; grade 3-4 dry eye; grade 5 severe dry eye). Eyes with SAC had significantly higher tear film lipid layer thickness ranges compared with the control eyes (P < 0.05). CONCLUSION: SAC was associated with advanced tear instability and thickening of the tear film lipid layer. Evaluation of the tear film lipid layer thickness might be useful in the assessment of the extent of dry eye disease and the treatment outcomes in patients with allergy.     

Clinical evaluation of measurement method for antigen specific IgE in tears of patients with allergic conjunctival disease

PURPOSE: To investigate a method for determining antigen specific IgE antibodies in tears of patients with allergic keratoconjunctival disease. SUBJECTS AND METHODS: Antigen specific IgE antibodies to Japanese cedar pollen or Housedust-Mites in tears of patients with allergic conjunctival diseases were examined. Both eyes in each patient were examined. The right eye was examined in normal healthy volunteers as a control. The number of eyes examined for IgE antibodies to Japanese ceder pollen was 32 eyes with seasonal allergic conjunctivitis(SAC), 12 eyes with perennial allergic conjunctivitis(PAC), 12 eyes with atopic keratoconjunctivitis (AKC), 4 eyes with vernal keratoconjunctivitis (VKC), and 12 eyes of the controls. The number of eyes examined for IgE antibodies to Housedust-Mites was 32 eyes with SAC, 20 eyes with PAC, 30 eyes with AKC, 22 eyes with VKC, and 10 eyes with the control. Tears were sampled by the method of Schirmer Test-1. Sampled tears were eluded with 200 microliters of phosphate buffered solution(pH 7.2, 0.05 M) and analyzed by the AlaSTAT-IMMULYZE method. Recovery rate of absorbance by filter paper for IgE antibodies in tears was determined by ratio to the standard sample of serum solution containing Housedust-Mite specific IgE antibodies with known concentration. RESULTS: Recovery rate of filter paper for IgE antibodies in tears was 83.6%. IgE antibodies in tears to Japanese cedar pollen were detected in 11 of 32 eyes of SAC. In other subjects, IgE antibodies were under the limit of the detection concentration except one eye of a patient with AKC. In the positive cases of Japanese cedar pollen specific IgE antibodies, there was no significant difference in the concentration between the right and the left eyes. IgE antibodies to Housedust-Mites were significantly higher not only in incidence but also in concentration in 18 of 22 eyes with VKC than in that in other in 8 of 20 eyes with PAC and 12 of 30 eyes with AKC. CONCLUSION: The method for determining antigen specific IgE antibodies in tears is clinically useful to diagnose and to investigate pathophysiology of allergic conjunctival diseases.     

Correlations between allergen-specific IgE serum levels in patients with allergic conjunctivitis in spring

Purpose: The purpose of this study was to evaluate the relation between various specific class E immunoglobulins (IgE) in serum and allergic conjunctivitis in spring. Methods: Forty patients with allergic conjunctivitis and fifty healthy volunteers were selected for this trial. Total IgE and specific IgE to twelve inhalant allergens were measured using the CAP system. Results: Specific IgE levels caused by cedar and cypress pollen, house dust, Dermatophagoides pteronyssinus , acarus, and moth allergens were higher in the allergy group than in the control group. No correlation was proven between the specific IgE levels and the total IgE level. The highest positivity rate for a specific allergen in patients with allergic conjunctivitis was 52.5% for cedar pollen, followed by cypress pollen at 37.5%. Conclusions: These results suggest that cypress pollen was the largest cause of allergic conjunctivitis and that the total IgE level had no correlation with each specific IgE.     

Relationship between myopia and allergen-specific serum IgE levels in patients with allergic conjunctivitis

Purpose: Various exogenous allergens can cause allergic conjunctivitis, whereas refractive errors are also related (as an endogenous factor) to the pathogenesis of allergic conjunctivitis. However, little is known about the interaction between exogenous and endogenous factors in patients with allergic conjunctivitis. We investigated the relationship between refractive errors and exogenous allergens in patients with allergic conjunctivitis. Methods: Sixty patients with allergic conjunctivitis and 60 healthy subjects (non‐allergy patients) were enrolled. Refraction was carried out in all subjects. In addition, total immunoglobulin E (IgE) and specific IgE levels for 12 inhaled allergens were measured by the capsulated hydrolic carrier polymer system. Results: The patients who were positive for‐specific IgE to indoor allergens had higher myopia than those who were negative, including those positive for house dust IgE (?3.66 ± 2.95 vs. ?1.05 ± 3.39, P = 0.0015), Dermatophagoides pteronyssinus (D. pteronyssinus) IgE (?3.50 ± 2.91 vs. ?1.01 ± 3.46, P = 0.0021), and acarus IgE (?3.45 ± 2.21 vs. ?1.51 ± 3.73, P = 0.0087), whereas antibody‐positive and antibody‐negative patients for outdoor allergens showed no significant differences of refraction. Refractions in indoor group (?3.58 ± 3.42) and indoor/outdoor (?3.70 ± 2.64) group were higher than those in outdoor group (?0.84 ± 2.30, P = 0.0047 and P = 0.0032) and the non‐allergy group (?1.30 ± 1.48, P = 0.0082 and P = 0.0054) [‐refraction] was significantly correlated with total IgE (r = 0.333, P = 0.0093), house dust (r = 0.355, P = 0.0054) and D. pteronyssinus (r = 0.379, P = 0.0028), while no correlation between refractive error and outdoor allergens was proven. Conclusion: These results suggest that specific IgE levels for indoor allergens, such as house dust, might be associated with refractive errors.     

Tear and serum IgE concentrations by Tandem-R IgE immunoradiometric assay in allergic patients

The authors studied a population of 39 allergic and 15 nonallergic patients, and determined their tear and serum IgE concentrations. Samples of tear and serum were tested for IgE by the Tandem-R immunoradiometric assay, which uses monoclonal antibody to produce a specific assay for IgE. The serum IgE levels in the study group showed a range from 23,280 to 16 IU/ml compared with controls of 72 to 2 IU/ml. Tear IgE in the study group varied from 159 IU/ml to less than 1 IU/ml compared with controls of 8 IU/ml to less than 1 IU/ml. A statistically significant correlation between tear and serum IgE exists in the allergic patients with eye symptoms. It also exists when serum IgE was greater than 100 IU/ml, the tear IgE greater than 4 IU/ml, or when both the serum IgE was greater than 100 IU/ml and the tear IgE greater than 4 IU/ml.     

Serum allergen specific immunoglobulin E levels in patients with allergic conjunctivitis

PURPOSE: To evaluate serum allergen specific immunoglobulin E (IgE) levels in patients with various types of allergic conjunctivitis. METHODS: Twenty-five patients with seasonal allergic conjunctivitis (SAC), 17 patients with perennial allergic conjunctivitis (PAC), and 10 patients with vernal conjunctivitis (VC) were included in the study. Specific IgE levels to Dermatophagoides pteronyssinus (Dp), Dermatophagoides farinae (Df), mixed grass pollens, and animal epithelia were measured using Pharmacia CAP system (Pharmacia Diagnostic AB, Uppsala, Sweden). RESULTS: The percentage of subjects with specific IgE against Dp and Df was statistically higher in VC (30%) compared to PAC (5.9%) and SAC (0%) (p=0.03). Specific IgE against mixed grass pollens was found in 30% of VC and 40% of SAC, whereas 10% of VC and 8% of SAC patients were found to be hypersensitive to animal epithelia. CONCLUSIONS: Allergic reaction against house dust mites and pollens was common in VC, whereas specific IgE against grass pollens was remarkable in SAC. IgE levels specific to various antigens might be measured by UNICAP system, which is a rapid and practical technology.     

疏风明目方超声雾化对过敏性结膜炎患者泪膜稳定性及泪液相关指标的影响

目的：观察疏风明目方超声雾化对过敏性结膜炎患者泪膜稳定性及泪液相关指标的影响。

方法：将140例过敏性结膜炎患者随机分为两组,对照组70例给予盐酸奥洛他定滴眼液联合生理盐水雾化治疗,观察组70例给予盐酸奥洛他定滴眼液联合疏风明目方超声雾化治疗。连续治疗14d后,比较两组临床疗效、治疗前后单项症状(流泪、痒感、畏光、异物感)、泪膜稳定性(BUT、FL)、泪液相关指标\〖嗜酸性细胞阳离子蛋白(ECP)、HA、IgE\〗。

结果：观察组治疗后总有效率高于对照组(90.7%vs 74.3%,P<0.05); 两组治疗后单项症状积分均低于治疗前,且观察组均低于对照组(P<0.05); 两组治疗后BUT均高于治疗前,FL均低于治疗前,且观察组改善程度均优于对照组(P<0.05); 两组治疗后泪液HA、ECP、IgE水平均低于治疗前,且观察组改善程度均优于对照组(P<0.05)。

结论：疏风明目方超声雾化治疗能够改善过敏性结膜炎患者泪液相关指标,提高泪膜稳定性,有助于缓解局部变态反应,改善患者临床症状。     

Tumor necrosis factor-alpha (TNF-alpha) in seasonal allergic conjunctivitis and vernal keratoconjunctivitis

PURPOSE: To quantify the presence of the proinflammatory cytokine tumor necrosis factor-alpha (TNF-alpha) in allergic conjunctivitis. MATERIALS AND METHODS: Tears and peripheral blood samples were collected from patients with seasonal allergic conjunctivitis (SAC, n=6), vernal keratoconjunctivitis (VKC, n=12), and normal subjects (CT, n=12). From an additional six nonactive allergic patients, tears were collected before and after specific conjunctival allergen challenge (CAC). Upper tarsal conjunctival biopsies were obtained from five CT and five VKC patients. TNF-alpha in tears was measured by enzyme-linked immunoassay and identified in tissues by immunohistochemistry. RESULTS: Tear TNF-alpha levels in VKC patients were significantly increased compared to CT (p=0.03), and were significantly correlated with the severity of the disease. No differences were found between SAC and CT tear samples. TNF-alpha serum levels were higher in VKC than CT, however, this difference was not statistically significant. After CAC, tear TNF-alpha levels were found increased in only one of six patients. In VKC tissues, TNF-alpha positive cells were significantly increased compared to CT (p=0.03). CONCLUSIONS: TNF-alpha may have a significant role in severe forms of allergic conjunctivitis.     

外周血CD4+T细胞表面信号淋巴细胞激活分子在过敏性结膜炎发病中的作用

目的　研究外周血中CD4⁺T细胞表面信号淋巴细胞激活分子（signaling lymphocytic activation molecule，SLAM）在过敏性结膜炎发病中的作用。方法　选取临床过敏性结膜炎患者10例作为病例组，健康体检者10例作为健康对照组。抽取静脉血，用ELISA法检测两组血清中总IgE的表达情况，同时用流式细胞术检测CD4⁺T细胞表面SLAM的表达情况，分析CD4⁺T细胞表面SLAM表达与血清中总IgE表达的相关性。另选取清洁级雌性两月龄Balb/c小鼠20只，随机分为对照组和模型组，每组各10只，第1天于模型组小鼠尾根、足垫皮下处注射弗氏佐剂和豚草花粉PBS液混合物，第7天、第14天腹腔注射强化，对照组用弗氏佐剂和PBS混合液代替；第15天，每只小鼠给予花粉蛋白粗浸液进行滴眼激发，激发后1 h，取眼球用于制作病理切片，收集静脉血用于流式细胞术检测CD4⁺T细胞表面SLAM的表达，ELISA法检测血清豚草花粉特异性IgE表达；分析两组小鼠外周血中SLAM、血清中特异性IgE的表达有无显著差异，并分析二者的相关性。结果　病例组外周血中CD4⁺T细胞表面SLAM表达明显低于健康对照组（P=0.016），病例组血清中总IgE表达明显高于健康对照组（P=0.002），病例组SLAM表达与总IgE呈负相关（r=-0.453，P＜0.05）。实验小鼠模型组外周血中CD4⁺T细胞表面SLAM表达较对照组显著降低（P=0.000），模型组血清中特异性IgE表达较对照组显著升高（P=0.000），模型组SLAM表达与特异性IgE呈负相关（r=-0.527，P＜0.05）。结论　过敏性结膜炎发病时，外周血中CD4⁺T细胞表面SLAM表达明显减少，与血清IgE的产生有一定的相关性，在一定程度上可以反映机体的过敏状态。     

无干眼症状儿童过敏性结膜炎中的泪膜稳定性研究

目的 观察无干眼症状的儿童过敏性结膜炎患者的泪膜稳定性。设计 回顾性病例系列。研究对象 无干眼症状的儿童季节性过敏性结膜炎患者30例（60眼）。无干眼症状的屈光不正患儿20例（40眼）为正常对照组。方法 受试者进行病史询问以及外眼、眼前节及干眼相关检查,包括泪膜破裂时间（BUT）、基础泪液分泌试验（SIt）、角膜荧光素染色（FL）。荧光素染色评分0~12分,无染色为0分。主要指标 BUT、SIt和FL评分。结果 观察组与对照组BUT分别为（7.35±2.46）s、（11.95±2.183）s（ t =9.569,P=0.000）;SIt分别为（18.28±5.123）mm、（16.50±5.149）mm（ t =1.702,P=0.092）;FL评分不为0者分别为13例（20眼）、6例（6眼）（χ2=4.193,P=0.041）。观察组中FL评分、BUT与病史长短无显著相关性。结论 无干眼症状的儿童季节性过敏性结膜炎患者也可能存在泪膜稳定性下降和角膜上皮完整性受损的改变。（眼科,2015,24：268-271）     

青蒿素在小鼠花粉过敏性结膜炎早期反应相中的作用

目的：：探讨青蒿素对小鼠花粉过敏性结膜炎早期反应相的免疫抑制作用。方法：选取Balb/c雌性小鼠25只,随机分为五组：A组：模型组;B组：青蒿素滴眼组;C组：青蒿素灌胃组;D组：地塞米松磷酸钠滴眼组;E组：阴性对照组。初次诱导采用小鼠尾根部及足垫皮下注射豚草花粉粗浸液与弗氏佐剂的混合液,第7 d和14 d加强致敏采用腹腔注射。阴性对照组使用等量的弗氏佐剂与PBS混合液代替。在第21~27 d进行治疗,青蒿素滴眼组给予1%青蒿素滴眼液滴眼,4次/d;青蒿素灌胃组按600mg/kg的剂量进行灌胃,1次/d;地塞米松磷酸钠滴眼组给予地塞米松磷酸钠滴眼液滴眼,4次/d;模型组及阴性对照组给予青蒿素滴眼液基质液滴眼。治疗后采用豚草花粉变应原滴眼激发后1h内,取眼球用于组织病理学检测,取血清用于豚草花粉特异性IgE测定。结果：模型组小鼠激发后过敏症状较其他各用药组明显严重;地塞米松磷酸钠滴眼组、青蒿素滴眼组及灌胃组过敏症状评分、肥大细胞脱颗粒比率及血清中豚草花粉特异性IgE浓度均高于阴性对照组,而显著低于模型组。结论：青蒿素滴眼及灌胃治疗均可明显抑制小鼠花粉过敏性结膜炎症状、早期反应相中肥大细胞脱颗粒比率和豚草花粉特异性IgE的产生,推测青蒿素对花粉过敏性结膜炎具有一定的治疗作用。     

过敏性结膜炎泪膜改变与干眼症的相关性浅析

目的：研究过敏性结膜炎泪膜功能的变化与干眼症发生的相关性,以更好的指导临床治疗。 方法：选取50例眼科门诊诊断为过敏性结膜炎的患者为观察组,按1∶1对照随机选取50例无眼表疾病、干眼症和全身疾病的健康人为对照组,分别进行角膜荧光素（ FL ）染色检查、泪膜破裂时间（BUT）、基础泪液分泌试验（SⅠt）、泪河线高度（ TMH）测量和裂隙灯检查。 结果：观察组左眼与右眼FL,SⅠt,BUT,TMH间存在相关性,差别有统计学意义（P〈0.05）;观察组与对照组患者FL、BUT评分差异有统计学意义（ P〈0.05）;观察组患者中TMH与SⅠt间呈正相关,FL与BUT呈负相关,且差别均具有统计学意义（P〈0.05）。 结论：过敏性结膜炎可因炎症介质的介入引发泪膜稳定性变化,从而导致干眼症发生。过敏性结膜炎泪膜稳定性变化与角膜上皮损害程度相关。     

The conjunctival epithelium in dry eye subtypes: effect of preserved and non-preserved topical treatments

PURPOSE: To determine the effect of topical treatments on the conjunctiva in dry eye. METHODS: N = 134 dry eye subjects were diagnosed using a protocol of McMonnies dry eye symptom survey score > 14, fluorescein break up time (FBUT) < 10 s and presence of rose Bengal staining. Differential diagnosis of dry eye subtypes was based on biomicroscopic signs and ocular/medical history. Superficial perilimbal bulbar conjunctival epithelial samples were collected using impression cytology. The nucleo-cytoplasmic ratio (N/C), goblet cell density (GCD) and expression of monoclonal antibodies HLA DR and CD23 were determined. The ocular surface characteristics of untreated subjects, those receiving preserved dry eye treatments and those receiving non-preserved treatments were compared with each other and with controls. Ocular surface characteristics of dry eye subtypes were also examined. RESULTS: An increase in N/C (p = 0.011), reduction in GCD (p = 0.0001) and increase in expression of HLA DR (p = 0.0001) and CD23 (p = 0.0001) were detected in the untreated group compared to controls. No significant differences were found between the group receiving non-preserved dry eye treatments and untreated dry eye group. The group receiving preserved treatments had a reduced GCD (p = 0.0003) and increased expression of HLA DR (p = 0.0003) and CD23 (p = 0.0001) compared to the group receiving non-preserved treatments. Dry eye subtype specific differences in HLA DR and CD23 expression were noted. CONCLUSIONS: The conjunctival inflammation and reduced goblet cell density of dry eye is exacerbated by use of preserved topical agents, and is not significantly improved by use of non-preserved artificial tear supplements alone. Therapeutic strategies for dry eye should aim to increase goblet cell density and control ocular surface inflammation.     

Relationship of symptomatology with closed chamber infrared thermometry and humidity in dry eyes

PURPOSE: To evaluate the relationship of symptoms of dry eye with closed chamber infrared thermometry and humidity measurements. METHODS: The authors studied 54 patients (108 eyes) with dry eye disorders of different grades of clinical severity (mean age 35.75+/-14.37 years), 31 cases (62 eyes) with normal eyes (mean age 33.68+/-14.42 years), and 10 cases (20 eyes) with epidemic conjunctivitis (mean age 33.68+/-14.42 years). The symptoms and the clinical tests (Schirmer-1 test, fluorescein tear break up time, Lissamine green stain; closed chamber infrared thermometry and humidity) were used to establish the diagnosis of dry eyes. The closed chamber humidity difference was used to classify the groups of dry eye. RESULTS: The authors noted no temperature difference from closed to open eye position in dry eyes as compared to 0.10 +/- 0.00 degrees C difference in normal eyes and epidemic conjunctivitis. Four groups of cases were identified by difference in values of humidity: Group 1 = <0.9 relative humidity (RH)% to 1 RH%; Group 2 = >1 RH% to 1.5 RH%; Group 3 = >1.5 RH% to 2 RH %; and Group 4 = >2 RH%. The symptomatology was measured in the eyes using Oxford scale (0-4) and correlated with the humidity groups. The grading of symptoms with the humidity showed a statistically significant relationship (p<0.0001) in each group. The severity of the symptoms showed an increase in frequency and severity from Group 1 to Group 4, which was statistically significant (p<0.0001). The mean sum total of global symptomatology score was statistically significant (p<0.0001): 3.43 +/- 0.31 in Group 1, 4.65+/-0.42 in Group 2, 8.56 +/- 0.78 in Group 3, and 13.35+/-1.21 in Group 4. However, total symptomatology score in epidemic conjunctivitis did not show a statistically significant value (p=0.20). CONCLUSIONS: The closed chamber humidity and thermometry measurements showed statistical correlation in all four groups of dry eyes to total mean symptomatology score (p<0.001) and showed an increase in value with increasing severity of symptoms. However, all individual symptoms fail to show any conclusive relationship.     

螨脱敏治疗变应性结膜炎的观察

目的 观察尘螨变应原疫苗治疗变应性结膜炎的效果.方法 采用病例自身对照的方法,比较2002～2007年间122例尘螨过敏的变应性结膜炎患者在脱敏治疗前后眼痒、眼充血的评分,比较血清尘螨特异性IgE及EOS水平.结果 122例患者完成脱敏治疗并进行了治疗前后相关指标的检测.眼痒积分由(2.2±1.1)降至(0.5±0.3)(P<0.01),眼充血由(1.8±0.9)降至(0.4±0.3)(P<0.01);血清尘螨slgE及EOS由治疗前的(41.01±6.96)KUA/L、(0.698±0.378)×109/L,分别降至(32.06±2.98)KUA/L(P>0.05)、(0.119±0.127)×109/L(P<0.01).临床完全控制率64.75%,良好控制率31.97%.122例中有8例出现轻度局部不良反应,2例出现全身不良反应.结论 尘螨过敏的变应性结膜炎患者进行尘螨特异性脱敏治疗是一种有效、安全的治疗方法.

Abstract：

Objective To evaluate the effect of desensitization therapy for the dust mites allergic conjunctivitis. Methods From 2002 to 2007, prospective and case controlled trial was designed to compare the scores of ocular itch and ocular hyperemia, levels of serum specific IgE and EOS before and after desensitization therapy of the 122 dust mites allergic conjunctivitis. Results There were 122 patients completed the therapy and in compliance with the evaluations. The scores of ocular itch decreased from (2.2± 1.1) before therapy to (0.5± 0.3) after therapy (P <0.01), ocular hyperemia decreased from (1.8± 0.9) before therapy to (0.4± 0.3) after therapy (P <0.01); levels of serum specific IgE of dust mites and EOS decreased from (41.01±6.96) KUA/L, (0.698± 0.378)× 109/L to (32.06± 2.98) KUA/L(P>0.05), (0.119± 0.127) × 109/L(P<0.01) respectively before and after therapy. 64.75% of the patients were clinically cured, 31.97% of them were clinically effective. There were 8 out of 122 patients appeared local side effects, and there were 2 out of 122 patients appeared systemic symptoms. Conclusion Dust mites specific desensitization therapy is an effective method for the dust allergic conjunctivitis.     

Documentation of the clinical picture of keratoconjunctivitis atopica in constitutional neurodermatitis

Among the author's patients a number of cases were identified with quite clear symptoms of atopic keratoconjunctivitis, and a photographic documentation was made. All of these patients had a history of allergy and a hereditary taint. In cooperation with dermatologists neurodermitis constitutionalis was diagnosed, and verified by determining the serum IgE concentration and the allergic specific antibody. The patients underwent conservative treatment with sodium cromoglycate, steroids and vasoconstrictors. In one case the authors used cryocoagulation with a successful result for intensive hyperplastic conjunctivitis.     

Clinical features of atopic keratoconjunctivitis

The clinical spectrum of ocular disease in 37 patients with atopic keratoconjunctivitis (AKC) is described. Patients typically had a severe blepharoconjunctivitis. Associated corneal scarring, suppurative keratitis, or keratoconus were the major causes of visual loss. Serum and tear samples from these patients were analyzed to quantify total and specific IgE antibodies. The results were compared as a case control study with results from samples from 55 patients with other forms of atopic disease and 16 nonatopic volunteers. Although the mean values for total and specific IgEs in the serum of patients with atopic disease were markedly higher than the values from nonatopic controls (P less than 0.00002), a difference between the disease groups could not be demonstrated (P greater than 0.05). There were also differences between both the total IgE (P = 0.0002) and pollen-specific IgE (P = 0.015) in tears from patients with atopic disease and nonatopic controls, but not for house dust mite or cat dander-specific IgEs. These results suggest that clinical differences between groups of patients with chronic allergic external eye disease are not associated with specific patterns of IgE production.