Allergens in Japanese patients with allergic conjunctivitis in autumn

PURPOSE: The purpose of the current study is to evaluate the relation between various specific class E immunoglobulins (IgE) in the serum and allergic conjunctivitis in autumn. METHODS: Total IgE and specific IgE to 12 inhalant allergens were measured using the CAP system in 32 patients with allergic conjunctivitis in spring (spring group), 27 patients with allergic conjunctivitis in autumn (autumn group), and 40 healthy volunteers (control group). RESULTS: Specific IgE levels caused by house dust, Dermatophagoides pteronyssinus, and orchard grass were higher in the autumn group than in the spring group. The highest positivity rate for a specific allergen was 51.9% for house dust, followed by D. pteronyssinus(48.1%) in the autumn group, while the highest rate was 68.8 % for cedar pollen, followed by cypress pollen (59.4%) in the spring group. Correlation analysis showed that house dust was significantly correlated with animal epithelia, D. pteronyssinus, acarus, and Alternaria tenuis in the autumn group (P<0.001). CONCLUSIONS: These results suggest that house dust is the main cause of allergic conjunctivitis during autumn. In spring, cypress pollen is the largest cause of allergic conjunctivitis, while indoor allergens such as house dust, animal epithelia, D. pteronyssinus, and acarus are not causative allergens in Japan.     

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.     

翼状胬肉患者中过敏性疾病和常见过敏源皮肤针刺试验阳性率

目的：评估翼状胬肉患者中过敏性疾病流行情况和皮肤针刺试验阳性率。

方法：62例翼状胬肉患者与年龄性别匹配的相同数量健康受试者纳入了这项研究。所有患者和健康受试者均接受眼科医生和过敏性疾病专科医生检查。皮肤针刺试验检测了常见致敏原。血清总IgE使用ELISA检测。

结果：过敏性鼻结膜炎在翼状胬肉患者中更多(19.3% vs 3.2%, P=0.002),但是在其他过敏性疾病或过敏症状上的差异没有统计学意义。皮肤针刺试验中,翼状胬肉患者对至少一种致敏原阳性的比率显著高于健康人(38.7% vs 6.5%, P=0.003)。蟑螂和尘螨是所调查翼状胬肉患者中最常见的致敏原(16.1%、12.9%)。

结论：本研究发现翼状胬肉患者中鼻结膜炎和皮肤针刺试验阳性率均较正常人高。     

儿童过敏性结膜炎与变应性疾病的相关性

目的评价儿童过敏性结膜炎与变应性鼻炎、哮喘及湿疹的相关性。方法对2005年9月～2006年9月在本院就诊的407例儿童过敏性结膜炎进行回顾性分析。对其鼻炎、哮喘、湿疹以及父母的过敏性疾病进行问卷式调查。对其中256例患者利用酶联吸附试验进行血清总IgE和特异性IgE分析。结果407例过敏性结膜炎中分别有292例(占71.7%)、376例(占92.4%)和115例(占28.2%)同时患有湿疹、鼻炎和哮喘,合并鼻炎者明显高于合并湿疹和哮喘者(P<0.05)。256例血清总IgE和特异性IgE检测中,吸入组230例中有228例(99.1%)总IgE呈阳性,食入组200例中198例(99.0%)总IgE呈阳性;吸入性过敏原以螨和屋尘为主,食入性过敏原以鱼、蟹、虾为主。慢性过敏性结膜炎的过敏原主要是螨、屋尘和鱼,与急性过敏性结膜炎的差异有统计学意义(P<0.05)。而急性过敏性结膜炎的过敏原主要是花粉和蒿草,与慢性过敏性结膜炎差异有统计学意义(P<0.05)。结论儿童过敏性结膜炎常与鼻炎、哮喘及湿疹同时发病,单独发病较少,其中儿童过敏性结膜炎与鼻炎发病尤为密切,故在儿童期联合治疗两种疾病将对防治鼻炎和过敏性结膜炎的发生...     

The significance of Vogt's striae in keratoconus as evaluated by in vivo confocal microscopy

Background: To evaluate the association of the presence, extent and width of Vogt's striae with other microstructural corneal alterations in keratoconus using in vivo confocal microscopy (IVCM). Methods: Sixty‐eight keratoconic corneas of 68 patients were evaluated with slit‐lamp examination (SLE), corneal topography and IVCM. For each eye, the presence, extent and width of alternating light and dark bands (Vogt's striae) observed using IVCM was recorded together with keratocyte and endothelial cell densities, stromal nerve thickness, subbasal nerve density and thickness. The refractive status and the mean and steepest corneal curvatures were noted. Results: Vogt's striae were present in 43 (63.2%) eyes on SLE and dark bands were present in 53 (77.9%) eyes on IVCM. Compared with patients without dark bands, patients with dark bands had significantly higher refractive errors in spherical equivalents (SE; ?8.15 ± 3.70 vs. ?5.18 ± 2.46 diopters [D], P = 0.007), higher astigmatic errors (?5.88 ± 2.69 vs. ?4.10 ± 1.84 D, P = 0.027), higher steepest corneal curvatures (54.33 ± 4.38 vs. 51.23 ± 3.72 D, P = 0.018), lower anterior stromal keratocyte densities (1106 ± 172 vs. 1222 ± 171 cells/mm², P = 0.022) and lower nerve fibre densities (18.74 ± 6.54 vs. 22.66 ± 6.47 nerves/mm², P = 0.054). Compared with patients in whom dark bands were confined to the posterior stroma, patients with dark bands extending into the anterior stroma had significantly higher refractive errors in SE (?11.17 ± 2.25 vs. ?6.34 ± 3.48 D, P < 0.001), higher astigmatic errors (?7.44 ± 2.56 vs. ?4.69 ± 2.22 D, P = 0.006) and wider bands (6.0 ± 2.1 vs. 9.6 ± 3.1 µm, P < 0.001). Conclusions: Vogt's striae appear to be more prevalent in keratoconic corneas than can be appreciated clinically. The presence of Vogt's striae may be associated with corneal topographic and microstructural changes.     

Conjunctival provocation test with Dermatophagoides pteronyssinus in the diagnosis of allergic conjunctivitis from house mites]

INTRODUCTION: Perennial conjunctivitis due to house dust mites is the most frequent form of allergic conjunctivitis in urban environments. However, its diagnosis remains difficult for ophthalmologists. In this study, we evaluated a conjunctival provocation test (CPT) using standardized extracts of Dermatophagoides pteronyssinus (Dpt) and compared it to the diagnostic methods commonly performed in allergology: prick tests with dust and house dust mites and specific and IgE assay. MATERIALS AND METHODS: We performed a CPT on 60 volunteer patients, between the ages of 8 and 64 years, corresponding to 30 patients sensitized to house dust mites with the presence of specific IgE and chronic conjunctivitis, 21 patients not sensitized to house dust mites but presenting features of chronic conjunctivitis, and 9 asymptomatic patients. A house dust mite desensitizing treatment was not an exclusion criterion for a number of allergic patients. CPTs were prepared from Dpt allergenic extracts (Laboratoires Stallergènes, Antony, France) with 5 progressive concentrations by dilution in a nonphenolic physiological solution: 1.2 RI, 3.7 RI, 11 RI, 33 RI, and 100 RI. CPTs were performed in only one eye and asymmetry of the ocular response was evaluated by the cumulative clinical score of Abelson Chambers and Smith. The correlation between the 2 diagnostic tests was established by calculating the Cohen correlation coefficient or kappa. We also evaluated the sensitivity and diagnostic specificity for each test. RESULTS: The statistical correlation between specific IgE and the other allergological tests in for allergic conjunctivitis to house dust mites was 0.93 for the CPT, 0.46 for the prick test to Dpt, and 0.33 for the prick test to dust. The diagnostic sensitivities and specificities for each test were 90% and 100% for the CPT, 60% and 70% for the prick test to dust, 70% and 76% for prick test to Dpt, respectively. Beyond an antigenic cut-off value of 11 RI, we also observed greater hypersensitivity reactions for patients with lacrimal IgE or elevated specific IgE levels. CONCLUSION: The results obtained with the CPT confirm its high antigenic quality. It is a particularly useful, rapid, and perfectly safe clinical test. It is the only test able to establish a relationship between ocular manifestations and specific I(8)E.     

Development of an animal model for allergic conjunctivitis: influence of genetic factors and allergen concentration on immune response

Purpose: Animal models of diseases are extremely important in the study of the physiopathogenesis of human diseases and for testing novel therapeutic interventions. The present study aimed to develop an animal model that simulates human allergic conjunctivitis and to study how allergic response may be influenced by the allergen dose used for immunization and by genetic factors. Methods: Sixty C57Bl/6 mice and 60 BALB/c mice were immunized with placebo, or 5 μg or 500 μg of allergen derived from Dermatophagoides pteronyssinus. After ocular challenge, the mice were examined in order to clinically verify the occurrence or not of conjunctivitis. Material obtained from animals was used for total and specific IgE and IgG1 dosage, for assays of Der p‐specific lymphocyte proliferation and supernatant cytokine dosage, and for histopathological evaluation of conjunctiva. Results: We developed a murine model of allergic conjunctivitis induced by D. pteronyssinus. The model is similar to human disease both clinically and according to laboratory findings. In mouse, conjunctivitis was associated with a Th2 cytokine profile. However, IL‐10 appeared to be involved with disease blockade. Mice of different strains have distinct immune responses, depending on the sensitization dose. Conclusions: The murine model developed is suitable for the study of immunopathogenesis and as a template for future therapies. Using BALB/c and C57BL/6 mice, we demonstrated that genetic factors play a role in determining susceptibility and resistance, as well as in establishing the allergen concentration needed to induce or to block disease development.     

不同类型间歇性外斜视斜视角不同测量方法的比较

目的:比较不同类型间歇性外斜视使用注视6m示标三棱镜检查、注视30m示标、注视户外示标、1h遮盖试验四种测量方法测量斜视角结果的差别。方法:前瞻性研究。收集2013-06/2014-06在青岛大学医学院附属医院被确诊为间歇性外斜视的患者65例,其中男37例,女28例,平均年龄12.5±6.2岁。分别对患者行注视6m示标斜视度测量、注视30m示标斜视度测量、注视户外示标斜视度测量、1h遮盖试验斜视度测量。根据测量远近斜视角差值大小,将患者分为基本型、集合不足型、分开过强型。对各型中测量的视远斜视度进行单因素方差分析,采用LSD-t方法进行两两比较。结果:注视6m示标、注视30m示标、注视户外示标、1h遮盖试验四种检测方法测得的视远斜视度在三型中分别为:基本型45.4±21.0,55.0±15.0,64.68±17.7,68.75±16.6PD;集合不足型33.3±14.0,44.9±12.9,43.6±11.8,54.6±11.2PD;分离过强型55.6±17.4,66.3±18.8,76.9±16.4,78.1±15.6PD,三型中四种方法测得的视远斜视度进行比较,结果均有统计学意义(F基本型=9.649,P=0.00;F集合不足型=6.886,P=0.001;F分离过强型=7.989,P=0.00)。两两比较,注视户外示标(P基本型=0.044,P分离过强型=0.048)及1h遮盖试验(P基本型=0.04,P分离过强型=0.027)与注视30m示标检查比较时,在基本型与分离过强型两型中差异均有统计学意义;注视户外示标检查与1h遮盖试验(P基本型=0.353,P分离过强型=0.815)在基本型与分离过强型两型中的比较差异无统计学意义。而在集合不足型中,与其它三种检查方法相比,1h遮盖试验检查结果明显更大,差异有统计学意义。结论:注视户外示标与1h遮盖试验可以测出基本型与分离过强型更大的斜视角,在集合不足型1h遮盖试验可以测出更大斜视角。     

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.     

氯雷他定联合双氯芬酸钠滴眼液治疗过敏性结膜炎临床研究

目的：：探讨氯雷他定联合双氯芬酸钠滴眼液治疗过敏性结膜炎的临床效果,以改善过敏性结膜炎患者预后。方法：选取过敏性结膜炎患者154例158眼,随机分为两组。对照组患者单纯给予氯雷他定片治疗,观察组患者在对照组基础上加用双氯芬酸钠滴眼液进行治疗。对两组患者症状和体征积分进行比较,并对治疗效果进行评价并比较。结果：治疗前,两组患者患眼症状积分和体征积分无统计学差异(P>0.05)。经过治疗,观察组患眼眼痒、流泪、畏光、烧灼感以及异物感积分分别为1.03±0.10、0.83±0.10、0.62±0.06、0.80±0.05和1.10±0.09分,结膜充血水肿、分泌物、睑结膜乳头滤泡、角膜缘改变、角膜上皮改变以及眼睑和球周组织水肿得分分别为0.95±0.08、0.63±0.05、1.32±0.13、0.67±0.06、0.72±0.06和0.55±0.04分,均明显低于对照组,两组比较差异有统计学意义(P<0.05)。对照组患者患眼显效、总有效率分别为30.4％和68.4％;观察组分别为50.6％和86.1％,观察组患者患眼显效率和总有效率均明显高于对照组,两组患眼比较差异有统计学意义(P<0.05)。结论：在全身使用氯雷他定的基础上给予双氯芬酸钠眼液点眼,可以更好地缓解过敏性结膜炎患者的临床症状和体征,提高治疗效果,而且给药方便,是一种有效的治疗方案。     

调体脱敏方加减内服配合眼部冷湿敷治疗过敏性结膜炎

目的:观察调体脱敏方加减内服配合眼部冷湿敷治疗过敏性结膜炎的临床疗效及对免疫功能的影响。方法:选择2020-07/2021-03经我院确诊的过敏性结膜炎患者160例320眼。将患者随机分为治疗组和对照组,治疗组80例160眼采用中药汤剂调体脱敏方加减内服配合眼部冷湿敷治疗,对照组80例160眼局部点0.05%氮卓斯汀滴眼液治疗。连续治疗14d后,观察两组症状体征评分、过敏性结膜炎生活质量问卷评分、血清免疫球蛋白IgG、IgA、IgE水平的变化。结果:两组患者症状体征评分和生活质量问卷评分均较治疗前有改善(P<0.05),且治疗组改善要优于对照组(P<0.05);两组血清免疫球蛋白IgG、IgA水平治疗前后无明显改善(P>0.05),治疗组治疗后IgE水平较治疗前有明显改善(P<0.05)。结论:调体脱敏方加减内服配合眼部冷湿敷治疗能改善过敏性结膜炎的临床症状,有助于缓解过敏反应,提高生活质量。     

Eye laterality: a comprehensive analysis in refractive surgery candidates

Purpose: To explore eye laterality (higher refractive error in one eye) and its association with refractive state, spherical/astigmatic anisometropia, age and sex in refractive surgery candidates. Methods: Medical records of 12 493 consecutive refractive surgery candidates were filtered. Refractive error (subjective and cycloplegic) was measured in each subject and correlated with eye laterality. Only subjects with corrected distance visual acuity (CDVA) of >20/22 in each eye were enrolled to exclude amblyopia. Associations between eye laterality and refractive state were analysed by means of t‐test, chi‐squared test, Spearman’s correlation and multivariate logistic regression analysis, respectively. Results: There was no statistically significant difference in spherical equivalent between right (?3.47 ± 2.76 D) and left eyes (?3.47 ± 2.76 D, p = 0.510; Pearson’s r = 0.948, p < 0.001). Subgroup analysis revealed (I) right eye laterality for anisometropia >2.5 D in myopic (?5.64 ± 2.5 D versus ?4.92 ± 2.6 D; p = 0.001) and in hyperopic (4.44 ± 1.69 D versus 3.04 ± 1.79 D; p = 0.025) subjects, (II) a tendency for left eye cylindrical laterality in myopic subjects, and (III) myopic male subjects had a higher prevalence of left eye laterality. (IV) Age did not show any significant impact on laterality. Conclusions: Over the full refractive spectrum, this study confirmed previously described strong interocular refractive correlation but revealed a statistically significant higher rate of right eye laterality for anisometropia >2.5 D. In general, our results support the use of data from one eye only in studies of ocular refraction.     

Effect of hinged lamellar keratotomy on post-keratoplasty astigmatism and vision

Purpose: To show that hinged lamellar keratotomy alone affects refraction and vision in post‐keratoplasty eyes. Methods: A retrospective, non‐comparative, interventional case series was conducted on 28 eyes of 26 patients who had two‐stage laser in situ keratomileusis (LASIK) after penetrating keratoplasty. Records were reviewed with respect to the hinged lamellar keratotomy component of the procedure. The interval between keratoplasty and keratotomy was at least 1 year, and the follow‐up period averaged 29 ± 10 days. The Automated Corneal Shaper with nasal hinge was used. In addition to basic empirical astigmatism calculations, the Alpins method of astigmatism analysis was also employed to ensure that the influence of changes in cylinder axis were correctly taken into account when calculating the refractive change. Results: Surgically induced astigmatism from hinged lamellar keratotomy was not statistically significant in this series; however, the range in values (?9.06 to +7.57 D) has potential clinical ramifications. Nearly 70% of cases studied experienced surgically induced astigmatism of at least 2 D. Mean preoperative uncorrected vision was logMAR 1.06 ± 0.41, which improved marginally postoperatively to logMAR 1.03 ± 0.44 (P = 0.36). Best spectacle‐corrected visual acuity averaged logMAR 0.21 ± 0.16 preoperatively, improving to logMAR 0.09 ± 0.15 (range ?0.18 to 0.42) postoperatively, which was a statistically significant improvement (P < 0.01). No difference in refractive or visual outcomes was identified when those with keratoconus were compared to those with other underlying corneal disease processes. Conclusion: Although mean surgically induced astigmatism was not statistically significant, hinged lamellar keratotomy caused considerable changes in astigmatism in nearly 70% of post‐keratoplasty eyes studied. This suggests that clinically significant inaccuracies may result if a one‐stage LASIK procedure is performed on such patients. The authors suggest that reassessment of refraction after keratotomy may improve refractive outcomes.     

Increase in macrophage migration inhibitory factor levels in lacrimal fluid of patients with severe atopic dermatitis

Background and aims of the study Atopic dermatitis is a chronic inflammatory skin disorder that often involves some ophthalmic features. Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine that is associated with the generation of cell-mediated immune responses. Although serum MIF levels may be elevated in severe atopic dermatitis, the quantity of MIF in regional ocular fluid remains unknown. We measured MIF levels in tears (lacrimal fluid) of patients with atopic dermatitis. Patients and methods Tear samples were collected from 16 patients with atopic dermatitis, 10 patients with allergic conjunctivitis, and 15 healthy control subjects. The clinical severity of atopic dermatitis was evaluated according to the Scoring Atopic Dermatitis (SCORAD) index. The index was calculated by summing the following scores: extent criteria, intensity criteria, and subjective symptoms. Macrophage migration inhibitory factor levels were determined by a human MIF enzyme-linked immunosorbent assay. All comparisons were two-tailed, and P values <0.01 were considered as statistically significant.Results The mean MIF concentration in lacrimal fluid collected from healthy control subjects was 0.69±0.2 ng/ml. The mean tear MIF levels were 17.87±6.3 ng/ml in moderate-to-severe atopic dermatitis (SCORAD≥15, P=0.002), 0.93±0.08 ng/ml in mild atopic dermatitis (SCORAD<15), and 2.76±0.86 ng/ml in allergic conjunctivitis (P=0.008).Conclusions A proinflammatory cytokine MIF level was elevated in tears as well as serum in cases of severe atopic dermatitis. These results suggest that MIF may play an important role in the induction or enhancement of ophthalmic features related to severe atopic dermatitis.     

不同方法构建小鼠过敏性结膜炎免疫耐受模型的比较

目的：采用不同方法构建乳鼠过敏性结膜炎免疫耐受模型，观察生命早期环境因素对过敏性结膜炎的影响。

方法：Balb/c乳鼠50只随机分为空白对照组、卵清蛋白(OVA)+皮下注射组、OVA+雾化吸入组、OVA+灌胃组、豚草花粉(RW)+皮下注射组、RW+雾化吸入组、RW+灌胃组、屋尘螨(HDM)+皮下注射组、HDM+雾化吸入组、HDM+灌胃组(n=5只/组)。除空白对照组外，各处理组乳鼠分别诱导免疫耐受，成年后再予以相应抗原。通过眼前段照相观察眼表情况，RT-qPCR法检测结膜RANTES、IL-17 mRNA相对表达水平，并通过ELISA法检测血清IL-17浓度。

结果：与空白对照组相比，结膜IL-17 mRNA相对表达水平在RW+灌胃组增高最为显著，RW+皮下注射组增高程度最低(均P<0.05)； 结膜RANTES mRNA相对表达水平在RW+灌胃组增高最为显著(P<0.001)。与空白对照组相比，除OVA+雾化吸入组和RW+皮下注射组外，其他处理组小鼠血清IL-17浓度增高(P<0.05)。

结论：小鼠生命早期皮下注射诱导过敏性结膜炎免疫耐受状态最佳。     

Contact lens fitting for post-radial-keratotomy residual myopia

Purpose: To formulate guidelines for contact lens fitting following radial keratotomy and to achieve a relationship between contact lens fitting parameters and refractive and keratometric parameters. Methods: Thirty‐five eyes of 30 patients who had post‐radial‐keratotomy residual myopia were evaluated for contact lens fitting. The base curve was selected by ‘hit and trial’ method until a proper fit was achieved, following which an over‐refraction was done and final power of the contact lens obtained. Results: The mean contact lens base curve was 43.04 ± 1.62 D, which was steeper than the postoperative keratometry by 2.35 ± 0.74 D. The base curve and the postoperative keratometry were correlated by regression analysis (r = 0.895, P < 0.001). The mean overall diameter of the contact lenses was 9.64 ± 0.08 mm. The mean contact lens power was 5.81 ± 3.07 D, which was more myopic than the residual myopia by 2.79 ± 1.67 D. Regression analysis showed definite correlation between the contact lens power and postoperative myopia (r = 0.854, P < 0.001). Conclusion: For correction of post‐radial‐keratotomy residual myopia, contact lens fitting parameters can be determined by a regression formula using keratometric and refractive values.     

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     

Eotaxin-1 (CCL11) up-regulation in tears during seasonal allergic conjunctivitis

Purpose To compare in-season eotaxin-1 levels in tears of patients suffering from seasonal allergic conjunctivitis (SAC) with (1) tears of normal subjects and (2) tears of SAC patients out of season.Methods Tears of 11 SAC patients and six control volunteers were collected during the pollen season. Tears of five SAC patients showing a strong sensitivity to grass pollen (skin-prick tests and specific serum IgE) were collected both in season and out of season. ELISA measured eotaxin-1 level.Results Eotaxin-1 concentration in tears of SAC patients [2,100±503 (SEM) pg/ml] and normal subjects (1,193±176 pg/ml) were significantly different (P=0.0049). Regarding allergic patients, the clinical score (sum of five allergic criteria) was significantly different in season and out of season (P=0.0043) as was also the case with eotaxin-1 concentration (P=0.024).Conclusions The eotaxin-1 concentration in tears of patients showing hay fever could confirm a diagnosis of seasonal ocular allergy.     

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。     

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.