Diretriz Latino-americana sobre o Diagnóstico e Tratamento da Alergia Ocular ­ Em nome da Sociedade Latinoamericana de Alergia, Asma e Imunologia (SLAAI) / Latin American Guideline on the Diagnosis and Treatment of Ocular Allergy ­ On behalf of the Latin American Society of Allergy, Asthma and Immunology (SLAAI)

A alergia ocular, também conhecida como conjuntivite alérgica (CA), é uma reação de hipersensibilidade mediada por imunoglobulina E (IgE) do olho desencadeada por aeroalérgenos, principalmente ácaros da poeira doméstica e pólen de gramíneas. Os sintomas geralmente consistem em prurido ocular ou periocular, lacrimejamento e olhos vermelhos que podem estar presentes durante todo o ano ou sazonalmente. A alergia ocular tem frequência elevada, é subdiagnosticada e pode ser debilitante para o paciente. É potencialmente danosa para a visão, nos casos em que ocasiona cicatrização corneana grave, e na maioria dos pacientes associa-se a outros quadros alérgicos, principalmente rinite, asma e dermatite atópica. É classificada em conjuntivite alérgica perene, conjuntivite alérgica sazonal, ceratoconjuntivite atópica e ceratoconjuntivite vernal. O diagnóstico procura evidenciar o agente etiológico e a confirmação se dá pela realização do teste de provocação conjuntival. O tratamento baseia-se em evitar o contato com os desencadeantes, lubrificação, anti-histamínicos tópicos, estabilizadores de mastócitos, imunossupressores e imunoterapia específica com o objetivo de obter o controle e prevenir as complicações da doença.

Ocular allergy, also known as allergic conjunctivitis, is an immunoglobulin E-mediated hypersensitivity reaction of the eye triggered by airborne allergens, primarily house dust mites and grass pollen. Symptoms usually consist of ocular or periocular itching, watery eyes, and red eyes that may be present year-round or seasonally. Ocular allergy has a high frequency, is underdiagnosed, and can be debilitating for the patient. It is potentially harmful to vision in cases of severe corneal scarring, and in most patients, it is associated with other allergic conditions, especially rhinitis, asthma, and atopic dermatitis. It is classified as perennial allergic conjunctivitis, seasonal allergic conjunctivitis, atopic keratoconjunctivitis, and vernal keratoconjunctivitis. Diagnosis seeks to identify the etiologic agent, and confirmation is given by conjunctival provocation testing. Treatment is based on avoiding contact with triggers, lubrication, topical antihistamines, mast cell stabilizers, immunosuppressants, and specific immunotherapy with the aim of achieving control and preventing disease complications.

Prueba cutánea con extractos alergénicos de pólenes y relación con signos clínicos de rinitis alérgica y asma bronquial en Camagüey, Cuba / Skin test with allergen extracts from pollens and relation to clinical signs of allergic rhinitis and bronchial asthma in Camagüey, Cuba

Los pólenes inciden sobre las mucosas provocando sensibilización alérgica, sin embargo, en Cuba son insuficientes los estudios sobre estos alergenos. Con el objetivo de conocer el comportamiento de Ambrosía psilostachya, Amaranthus leucocarpus, Helianthus annuus, Rumex acetosella, Lolium perenne, Cupressus lindley y Cocos nucifera, se realizó un estudio observacional analítico en el Servicio de Alergia del policlínico Previsora, Camagüey. La muestra fue de 529 individuos con rinitis o asma, con pruebas cutáneas por punción (prick test) positivas a los ácaros, hongos y pólenes; el 40 por ciento de la misma estaba sensibilizada a pólenes con prueba de provocación nasal a estos alergenos. Se compararon según gravedad de los síntomas y los valores del habón de 3, 4 y 5 mm. Los grupos etarios con valores más altos de sensibilización fueron los de 6 a 12 y 19 a 44 años. No hubo diferencias significativas de sensibilización a los pólenes según sexo. Ambrosía y Lolium presentaron los porcentajes más altos de respuesta cutánea, con habones de 3 mm en un 49,98 por ciento y 40,09 por ciento, respectivamente. Tampoco se detectaron diferencias significativas. El 89,6 por ciento de los pacientes sensibilizados reaccionaron clínicamente a la provocación nasal. En los asintomáticos predominaron los habones de 3 mm y en los graves los de 5 mm. Los pólenes constituyeron una causa importante de sensibilización alérgica. Existió relación entre las pruebas cutáneas y la prueba de provocación nasal. El diámetro del habón de la respuesta cutánea a prick test se relacionó con la severidad de los síntomas clínicos(AU)

Although different types of pollens affect mucosal surfaces to trigger allergic sensitization, there are not enough studies on these allergens in Cuba. The objective of our research was to elucidate the behavior of Ambrosía psilostachya, Amaranthus leucocarpus, Helianthus annuus, Rumex acetosella, Lolium perenne, Cupressus lindley y Cocos nucifera. An analytical-observational study was conducted at the Allergy Service of the Previsora Clinic, Camagüey. The sample consisted of 529 patients with Rhinitis or Asthma and a positive skin test to mites, fungi and pollens. Forty percent of the sample showed sensitivity to pollens after a nasal challenge test. The cases were compared according to symptoms severity and wheal diameter: 3, 4 and 5 mm. The age groups with the highest degree of sensitization were 6-12 and 19-44 years of age, respectively. There were no significant differences of sensitization to pollens according to sex. Ambrosia y Lolium showed the highest percentages of skin response with wheals of 3 mm in 49,98 percent and 40.09percent, respectively. However no significant differences were detected. The 89,6percent of sensitized patients react clinically to nasal challenge test. Wheels of 3 mm were predominant in asymptomatic subjects while wheels of 5 mm in serious ones. Pollens were the most important cause of allergic sensitization. There was relation between skin and nasal challenge tests. The wheel diameter of skin response to the prick test was correlated to the severity of clinical symptoms(AU)