Diagnóstico de conjuntivitis folicular aguda: un análisis retrospectivo de 5 años en un centro de referencia / Diagnosis of acute follicular conjunctivitis: A 5-year retrospective analysis in a referral center

OBJETIVO Y MÉTODOS: Para determinar la frecuencia de la conjuntivitis folicular aguda, se analizó de manera retrospectiva los expedientes médicos en un centro de referencia en México durante un periodo de 5 años. RESULTADOS Y CONCLUSIONES: Un total de 859.986 consultas oftalmológicas fueron otorgadas, de las cuales 8.930 fueron diagnosticadas con conjuntivitis folicular aguda (1,03% del total). En la mayoría de los meses hubo un rango entre 100 y 200 pacientes. En agosto de 2012 se observó un aumento con 308 casos, disminuyendo después de 2 meses. Nuestro estudio no demostró una mayor frecuencia por mes, con excepción del año 2012 que presentó un pico en la incidencia durante el tercer trimestre

OBJECTIVE AND METHODS: A retrospective analysis was performed using the medical records in a referral center in Mexico over a period of 5 years, in order to determine the frequency of acute follicular conjunctivitis. RESULTS AND CONCLUSIONS: A total of 859,986 ophthalmology consultations were given, from which 8,930 were diagnosed with acute follicular conjunctivitis (1.03% of the total). The number of patients diagnosed range between 100 and 200 in the majority of months. In August 2012 an increase was observed with 308 cases, and then decreasing after two months. This study did not demonstrate a highest frequency by month, with exception of year 2012 that showed a peak incidence in the third trimester

Pharmacoeconomics of anterior ocular inflammatory disease.

PURPOSE OF REVIEW: Anterior ocular inflammatory disease (AOID) affects more that 40% of the U.S. population, which includes ocular allergies, various forms of infectious conjunctivitis, and dry eye diseases (tear film dysfunction). This review evaluates the recent economic costs of AOID treatment. RECENT FINDINGS: Rapid advances in pharmacotherapy of the anterior surface of the eye have been made as the expansion of the immunopathophysiology underlying these disorders ranging from the innate Toll-like receptors to the more specific IgE receptors are being unravelled. Even with these advances in AOID immunopathophysiology, progressive new treatments that address inflammatory mediators and their receptors with advancements in the development of ophthalmic remain limited. In 2011, AOID represents 40% of cost associated with ophthalmic drugs focusing on dry eye (31%), anti-infectives (30%), anti-allergics (25%), and anti-inflammatory agents (14%). With rising treatment costs, a need for cost-effective medicines remains to be pursued along with the development of treatment algorithms to maximize the therapeutic outcomes. SUMMARY: The economic burden of AOID has dramatically increased in recent years, with prescription drug expenditure approaching approximately $7 billion. There is an increasing need for major investment in this sector to improve outcomes as well as provide more effective alternative treatment modalities to the current options.

Epidemiology and burden of rhinitis and rhinoconjunctivitis in 9- to 11-year-old children.

BACKGROUND: Rhinoconjunctivitis (RC) is regarded as the most common chronic disease of childhood; however, the currently available epidemiological studies on prevalence, burden, and risk factors of RC are insufficient. This analysis aimed to investigate potential risk factors, symptom frequency, and burden of RC. METHODS: Using the International Study of Asthma and Allergies in Childhood Phase II questionnaires, 6963 elementary school children aged 9-11 years were surveyed in five different city centers of Turkey. All participants were skin-prick tested with common aeroallergens. RESULTS: The prevalence of ever rhinitis, physician-diagnosed rhinitis, current rhinitis, and current RC were 51.6, 31.0, 43.5, and 23.1%, respectively; 19.8% of children with RC symptoms were atopic to at least one allergen. Among students with RC symptoms, 42.2, 23.9, 35.8, and 28.2% reported moderate-severe interference of daily activities, at least 1 day of absence from school, visit to a health care professional, and any drug usage for rhinitis, respectively. Nasal decongestants and oral antihistamines were the most frequently used treatment. Approximately 70% of RC patients reported perennial symptoms and 42.8% were classified as mild to intermittent. Multivariate logistic regression analysis revealed family history of asthma and/or allergic rhinitis (odds ratio [OR] = 1.863; confidence interval, [CI] = 1.583-2.191; p < 0.001), living in a house with mold and dampness in the 1st year of life (OR = 1.651; CI = 1.356-2.01; p < 0.001), maternal smoking in pregnancy (OR = 1.425; CI = 1.089-1.864; p = 0.011), low monthly income (OR = 1.685; CI = 1.422-1.998; p = 0.001), current wheezing (OR = 2.543; CI = 2.151-3.006; p = 0.001), and current atopic eczema (OR = 2.503; CI = 1.96-3.196; p = 0.001) as significant risk factors for current RC. CONCLUSION: Along with the high prevalence of RC in childhood, underdiagnosis and undertreatment of the disease are also frequent. The socioeconomic burden of the disease can be reduced by increasing awareness and proper diagnosis/treatment.

Acute conjunctivitis: truth and misconceptions.

OBJECTIVE: Acute conjunctivitis is an extremely common condition and can be associated with significant morbidity and economic burden. Despite this, considerable controversy exists pertaining to the prevalence, diagnosis, management, and treatment of the condition. A panel of ophthalmology experts was assembled to review and discuss the current evidence based literature as it pertains to each of these persistent controversies. METHODS AND SCOPE: An acute conjunctivitis round table symposium was convened at the American Academy of Ophthalmology meeting in Atlanta, November 2008. The expert panelists consisted of four academic ophthalmologists in the field of cornea and external disease, whose discussion was informed by an English language literature survey carried out on the PubMed database for the period of January 1972 to October 2008. A narrative summary was generated from the literature review and direct transcription of this event, from which this Review article was developed. FINDINGS AND CONCLUSIONS: Considerable light has been shed on acute microbial conjunctivitis and especially those cases caused by adenovirus. Many of the myths that have perpetuated for years have been debunked by emerging evidence. The advent and the implementation of better diagnostic tools and anti-viral medications will help clinicians to improve their diagnostic accuracy, improve management and treatment decisions, and ultimately benefit patients while saving overall healthcare costs.