ABSTRACT
As alergias oculares englobam uma série de doenças inflamatórias da superfície ocular, causadas por diferentes mecanismos de hipersensibilidade. Acometem aproximadamente 20% da população e podem ser classificadas em formas mediadas por hipersensibilidade tipo I (CAS, CAP), tipo I e IV (CCV, CCA) e tipo IV (BCC, CPG). As formas mais prevalentes são CAS e CAP. As formas crônicas (CCV, CCA) estão mais frequentemente relacionadas a complicações e comprometimento da função visual decorrentes do processo inflamatório e consequente remodelação da superfície ocular. Comorbidades como olho seco e ceratocone podem estar presentes. O tratamento envolve diagnóstico e afastamento dos fatores etiológicos envolvidos, uso de drogas anti-inflamatórias que atuem na ação de linfócitos Th2, eosinófilos, mastócitos e células dendríticas Avanços no conhecimento da ativação e tráfego de células do sistema imune têm sido promissores na perspectiva de novas abordagens terapêuticas.
Ocular allergies encompass a number of inflammatory diseases in the ocular surface which have different hypersensitivity mechanisms and occur in 20% of population. They can be classified as being type I hypersensitivity mediated (PAC, SAC), type I and IV (VKC, AKC) and type IV (BKC, GPC). The most prevalent forms are PAC and SAC. The chronic presentations are mostly related to visual impairment due to remodeling in the ocular surface caused by chronic inflammation. Dry eye disease and keratoconus are comorbidities observed in severe cases. The management is based on accurate diagnosis, avoidance of etiological factors and the rational use of drugs that control the inflammatory events caused by Th2 driven. The advances in knowledge on activation and traffic of immune cells are providing new drugs and many perspectives on different approaches.
Subject(s)
Humans , Conjunctivitis, Allergic/physiopathology , Conjunctivitis, Allergic/drug therapy , Drug Hypersensitivity , Hypersensitivity, Immediate , Immunoglobulins , KeratoconjunctivitisABSTRACT
Neste artigo, os autores fazem uma revisão bibliográfica sobre a conjuntivite alérgica e seus subtipos, abordando suas manifestações clinicas, fisiopatologia, diagnóstico e manejo específicos.
Subject(s)
Conjunctivitis, Allergic , Conjunctivitis, Allergic/classification , Conjunctivitis, Allergic/diagnosis , Conjunctivitis, Allergic/physiopathologyABSTRACT
En el presente artículo revisaremos los aspectos más relevantes de la alergia ocular: su epidemiología, fisiopatología, cuadros clínicos y su terapéutica. Se encontrará una descripción más detallada de la fisiopatología ya que es, sin duda, la base del éxito terapéutico
In the present article we will review the most important aspectsof ocular allergy: its epidemiology, physiopathology, clinicalcharacteristics and treatment. A more detailed description ofthe physiopathology is addressed because is the basis for asuccessful treatment.
Subject(s)
Humans , Eye Diseases/physiopathology , Eye Diseases/drug therapy , Hypersensitivity/physiopathology , Hypersensitivity/drug therapy , Conjunctivitis, Allergic/physiopathology , Conjunctivitis, Allergic/drug therapy , Eye Diseases/immunology , Hypersensitivity/immunology , Immunologic Factors/therapeutic useABSTRACT
Allergic disorders affect 15% of human beings worldwide. The eyes are involved in most allergic conditions, which varies in severity from mild allergic conjunctivitis to severe and chronic inflammation of the conjunctiva and cornea with loss of vision. In this review article, we discuss the allergic kerato conjunctivitis with emphasis on pathophysiology and treatment modalities. We searched the Medline database by queries: "allergic conjunctivitis", "atopic conjunctivitis", "vernal conjunctivitis, and "giant papilla" Relevant English language articles from 1965 to 2006 were retrieved and studied. Regarding the chronic nature of the condition and the adverse effects of long term usage of certain medications, it is very important to explain the nature of the condition to the patients. Conservative management and administration of safe drugs such as mast cell stabilizer are the first option. Surgical interventions in these eyes like penetrating keratoplasty should be performed during remission of the inflammation
Subject(s)
Conjunctivitis, Allergic/physiopathology , Conjunctivitis, Allergic/therapy , Conjunctivitis, Allergic/surgery , Anti-Allergic Agents , Keratoplasty, PenetratingABSTRACT
The objective of this study was to develop a disease-specific questionnaire for patients with rhinoconjunctivitis. All patients were recruited at the Out-Patient Clinic at Siriraj Hospital. Related topics were gathered from several sources, and a list of 63 items was produced. In phase I, the first version of the questionnaire was completed by 363 patients. Forty-eight items were identified by clinical impact analysis during the item removal process, two more questions were then added, giving a total of 50. Two hundred and forty-three patients completed the second version questionnaire in phase II. The average time taken to complete the questionnaire was 6.38 minutes. The item removal process in phase II was achieved by a multi-step process. There were 36 items in the third version questionnaire which consisted of six dimensions and two independent items as follows: symptoms (17 items), physical functioning (3 items), role limitations (3 items), sleep (3 items), social functioning (3 items), emotions (5 items), general health (1 item), and absenteeism (1 item). The scores of each item ranged from 1 to 5; a lower score indicating a better quality of life. Data from the selected 36 items was extracted to test the validity and reliability of the final version. The floor and ceiling effects of the scores for each dimension were low. Multitrait multi-item analysis was conducted to examine construct validity. The scaling success of convergent and divergent validity was 100% and 94%, respectively. Internal consistency determined by Cronbach's alpha coefficient, was satisfactory (0.79-0.87). The study indicates that the questionnaire is suitable for use in clinical settings. While the test results are encouraging, further work needs to be done on the test-retest reliability and on responsiveness.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Conjunctivitis, Allergic/physiopathology , Female , Humans , Male , Middle Aged , Quality of Life , Surveys and Questionnaires , Reproducibility of Results , Rhinitis, Allergic, Seasonal/physiopathology , ThailandABSTRACT
Objetivo: Apresentar uma breve revisäo sobre doenças oculares alérgicas, tendo em vista a prevalência destas doenças na prática médica diária. Metodologia: Levantamento bibliográfico sobre os principais aspectos das conjutivites alérgicas, comentando-se em particular as características clínicas, fisiopatológicas e terapêuticas dos principais tipos descritos na literatura. Resultado: A maioria das doenças oculares discutidas nesta revisäo apresentam um mecanismo imunológico claramente estabelecido, enquanto em outras o mesmo é apenas sugerido. Conclusäo: O conhecimento geral destas doenças é de extrema importância para o alergista, pois embora näo representem a doença alérgica mais comum, a intensidade do quadro pode ser de grande significância clínica.
Subject(s)
Humans , Conjunctivitis, Allergic/physiopathology , Conjunctivitis, Allergic/drug therapy , PrevalenceABSTRACT
La conjuntivitis alérgica es uno de los padecimientos oculares más comunes y uno de los principales motivos de la consulta médica. El ojo es un órgano que frecuentemente se va afectando por procesos inflamatorios en las reacciones alérgicas locales y sistémicas, involucrando en la mayoría de las casos a la conjuntiva. Los términos de alergia ocular y conjuntivitis alérgica son utilizados indistintamente. En muchos países la conjuntivitis es tratada en sistema de atención primaria y sólo una pequeña proporción de los casos son vistos por especialistas en oftalmología o alergia. Por lo tanto, la mejor comprensión de la fisiopatología dará mayores oportunidades para el tratamiento adecuado de esta enfermedad
Subject(s)
Humans , Child , Conjunctivitis, Allergic/classification , Conjunctivitis, Allergic/etiology , Conjunctivitis, Allergic/physiopathologySubject(s)
Humans , Conjunctivitis, Allergic/drug therapy , Histamine H1 Antagonists/therapeutic use , Ketotifen/therapeutic use , Conjunctivitis, Allergic/physiopathology , Conjunctivitis, Allergic/therapy , Histamine H1 Antagonists/administration & dosage , Ketotifen/administration & dosage , Ophthalmic Solutions/therapeutic useABSTRACT
La conjuntivitis alérgica es una entidad clínica que se caracteriza por una afección inflamatoria a la conjuntiva ocular, ocasionado por un sinnúmero de alergenos (aeroalergenos, sustancias físicas y químicas, etc.) y que clínicamente se presenta con enrojecimiento de la conjuntiva, acompañado de prurito, lagrimeo, fotofobia, quemosis, los cuales pueden presentarse en forma estacional o perenne. Mencionaremos también que en la conjuntivitis alérgica participa todo tipo de respuesta inmunológica (humoral y celular) por lo que la orientación del tratamiento está hacia estos aspectos
Subject(s)
Humans , Conjunctivitis, Allergic/classification , Conjunctivitis, Allergic/etiology , Conjunctivitis, Allergic/physiopathology , Conjunctivitis, Allergic/immunology , Conjunctivitis, Allergic/therapy , KeratoconjunctivitisABSTRACT
las conjutivitis alérgicas son padecimientos que en general se presentan frecuentemente asociadas a otras enfermedades atópicas, por eso es de suma importancia conocer sus diversos tipos, su fisiopatología, los factores desencadenantes, cuadro clínico y tratamiento
Subject(s)
Allergens , Conjunctivitis, Allergic/classification , Conjunctivitis, Allergic/physiopathology , Conjunctivitis, Allergic/immunology , Hypersensitivity/etiology , Hypersensitivity/immunologySubject(s)
Humans , Administration, Topical , Conjunctivitis, Allergic/drug therapy , Histamine Antagonists/therapeutic use , Rhinitis, Allergic, Seasonal/drug therapy , Conjunctivitis, Allergic/physiopathology , Histamine Antagonists/administration & dosage , Histamine H1 Antagonists/administration & dosage , Histamine H1 Antagonists/pharmacology , Histamine H1 Antagonists/therapeutic use , Rhinitis, Allergic, Seasonal/physiopathology , Rhinitis, Allergic, Perennial/physiopathology , Rhinitis, Allergic, Perennial/drug therapyABSTRACT
O olho e seus anexos compreendem um sistema orgânico complexo, no qual fatores alérgicos e imunológicos frequentemente ocorrem. Existem eventos que ocorrem localmente, como a conjuntivite alérgica, bem como reaçöes que aparecem fazendo parte de uma doença imunológica sistêmica, como é o caso da Episderite Papilar Gigante (CPG), relacionada com o uso de lentes de contato, portanto atual em relaçäo à evoluçäo dos costumes, como exemplo de patologia ocular de origem alérgica