Vernal keratoconjunctivitis revisited: A case series of 195 patients with long-term followup

Stefano Bonini, Sergio Bonini, Alessandro Lambiase, Stefano Marchi, Patrizio Pasqualetti, Ornella Zuccaro, Paolo Rama, Laura Magrini, Tomas Juhas, Massimo G. Bucci

Research output: Contribution to journalArticle

Abstract

Objective: This Study aimed at revisiting vernal keratoconjunctivitis (VKC) on the basis of anamnestic, clinical, immunologic, histopathologic, and followup data of 195 patients. Design: Retrospective noncomparative case series. Participants: One hundred and ninety-five patients with VKC. Methods: Clinical evaluation and outcome in 151 of 195 patients with a median followup of 47 months. Evaluation was by telephone survey in 69 patients. Main Outceme Measures: (1) Demographic, clinical, and immunologic features of VKC and their influence on the course of the disease; (2) conjunctival and corneal complications and efficacy of treatment observed during the followup period. Results: VKC is a chronic disease. More than 60% of patients had repeated recurrences all year round. Males had an earlier presentation of symptoms than females and the male/female ratio decreased with age. Major (greater than 80%) and minor (up to 80%) diagnostic criteria were defined for clinical signs and symptoms of the disease. Negative skin test or radioallergosorbent test was present in approximately 50% of patients, whereas eosinophil infiltration was a constant histopathologic finding. A marked conjunctival sensitivity to nonspecific stimuli was noted in more than one third of patients. In 6% of cases, a reduction of visual acuity resulted from corneal scarring, and in 2% of patients, steroid-induced glaucoma was observed. The large size of giant papillae indicates poor prognosis for the persistence of the disease and its evolution into a chronic, perennial condition. Conclusions: VKC is a chronic eosinophilic disease of the ocular surface involving IgE, non IgE-mediated mechanisms, and age-sex-related influences. Although the disease has a good prognosis, severe visual impairments may result from long-standing inflammation. (C) 2000 by the American Academy of Ophthalmology.

Original languageEnglish
Pages (from-to)1157-1163
Number of pages7
JournalOphthalmology
Volume107
Issue number6
DOIs
Publication statusPublished - 2000

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Allergic Conjunctivitis
Immunoglobulin E
Chronic Disease
Radioallergosorbent Test
Vision Disorders
Skin Tests
Telephone
Eosinophils
Glaucoma
Visual Acuity
Signs and Symptoms
Cicatrix
Steroids
Demography
Inflammation
Recurrence

ASJC Scopus subject areas

  • Ophthalmology

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Bonini, S., Bonini, S., Lambiase, A., Marchi, S., Pasqualetti, P., Zuccaro, O., ... Bucci, M. G. (2000). Vernal keratoconjunctivitis revisited: A case series of 195 patients with long-term followup. Ophthalmology, 107(6), 1157-1163. https://doi.org/10.1016/S0161-6420(00)00092-0

Vernal keratoconjunctivitis revisited : A case series of 195 patients with long-term followup. / Bonini, Stefano; Bonini, Sergio; Lambiase, Alessandro; Marchi, Stefano; Pasqualetti, Patrizio; Zuccaro, Ornella; Rama, Paolo; Magrini, Laura; Juhas, Tomas; Bucci, Massimo G.

In: Ophthalmology, Vol. 107, No. 6, 2000, p. 1157-1163.

Research output: Contribution to journalArticle

Bonini, S, Bonini, S, Lambiase, A, Marchi, S, Pasqualetti, P, Zuccaro, O, Rama, P, Magrini, L, Juhas, T & Bucci, MG 2000, 'Vernal keratoconjunctivitis revisited: A case series of 195 patients with long-term followup', Ophthalmology, vol. 107, no. 6, pp. 1157-1163. https://doi.org/10.1016/S0161-6420(00)00092-0
Bonini S, Bonini S, Lambiase A, Marchi S, Pasqualetti P, Zuccaro O et al. Vernal keratoconjunctivitis revisited: A case series of 195 patients with long-term followup. Ophthalmology. 2000;107(6):1157-1163. https://doi.org/10.1016/S0161-6420(00)00092-0
Bonini, Stefano ; Bonini, Sergio ; Lambiase, Alessandro ; Marchi, Stefano ; Pasqualetti, Patrizio ; Zuccaro, Ornella ; Rama, Paolo ; Magrini, Laura ; Juhas, Tomas ; Bucci, Massimo G. / Vernal keratoconjunctivitis revisited : A case series of 195 patients with long-term followup. In: Ophthalmology. 2000 ; Vol. 107, No. 6. pp. 1157-1163.
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T2 - A case series of 195 patients with long-term followup

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AU - Lambiase, Alessandro

AU - Marchi, Stefano

AU - Pasqualetti, Patrizio

AU - Zuccaro, Ornella

AU - Rama, Paolo

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AU - Juhas, Tomas

AU - Bucci, Massimo G.

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N2 - Objective: This Study aimed at revisiting vernal keratoconjunctivitis (VKC) on the basis of anamnestic, clinical, immunologic, histopathologic, and followup data of 195 patients. Design: Retrospective noncomparative case series. Participants: One hundred and ninety-five patients with VKC. Methods: Clinical evaluation and outcome in 151 of 195 patients with a median followup of 47 months. Evaluation was by telephone survey in 69 patients. Main Outceme Measures: (1) Demographic, clinical, and immunologic features of VKC and their influence on the course of the disease; (2) conjunctival and corneal complications and efficacy of treatment observed during the followup period. Results: VKC is a chronic disease. More than 60% of patients had repeated recurrences all year round. Males had an earlier presentation of symptoms than females and the male/female ratio decreased with age. Major (greater than 80%) and minor (up to 80%) diagnostic criteria were defined for clinical signs and symptoms of the disease. Negative skin test or radioallergosorbent test was present in approximately 50% of patients, whereas eosinophil infiltration was a constant histopathologic finding. A marked conjunctival sensitivity to nonspecific stimuli was noted in more than one third of patients. In 6% of cases, a reduction of visual acuity resulted from corneal scarring, and in 2% of patients, steroid-induced glaucoma was observed. The large size of giant papillae indicates poor prognosis for the persistence of the disease and its evolution into a chronic, perennial condition. Conclusions: VKC is a chronic eosinophilic disease of the ocular surface involving IgE, non IgE-mediated mechanisms, and age-sex-related influences. Although the disease has a good prognosis, severe visual impairments may result from long-standing inflammation. (C) 2000 by the American Academy of Ophthalmology.

AB - Objective: This Study aimed at revisiting vernal keratoconjunctivitis (VKC) on the basis of anamnestic, clinical, immunologic, histopathologic, and followup data of 195 patients. Design: Retrospective noncomparative case series. Participants: One hundred and ninety-five patients with VKC. Methods: Clinical evaluation and outcome in 151 of 195 patients with a median followup of 47 months. Evaluation was by telephone survey in 69 patients. Main Outceme Measures: (1) Demographic, clinical, and immunologic features of VKC and their influence on the course of the disease; (2) conjunctival and corneal complications and efficacy of treatment observed during the followup period. Results: VKC is a chronic disease. More than 60% of patients had repeated recurrences all year round. Males had an earlier presentation of symptoms than females and the male/female ratio decreased with age. Major (greater than 80%) and minor (up to 80%) diagnostic criteria were defined for clinical signs and symptoms of the disease. Negative skin test or radioallergosorbent test was present in approximately 50% of patients, whereas eosinophil infiltration was a constant histopathologic finding. A marked conjunctival sensitivity to nonspecific stimuli was noted in more than one third of patients. In 6% of cases, a reduction of visual acuity resulted from corneal scarring, and in 2% of patients, steroid-induced glaucoma was observed. The large size of giant papillae indicates poor prognosis for the persistence of the disease and its evolution into a chronic, perennial condition. Conclusions: VKC is a chronic eosinophilic disease of the ocular surface involving IgE, non IgE-mediated mechanisms, and age-sex-related influences. Although the disease has a good prognosis, severe visual impairments may result from long-standing inflammation. (C) 2000 by the American Academy of Ophthalmology.

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