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Angela Castegnaro, Federico Piliego, Daniela Lazzarini, Alvise La Gloria Valerio, Paolo Mattana, Iva A Fregona, Andrea Leonardi; Allergic conjunctivitis: a national cross-sectional study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2491.
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Ocular allergy is one of the most common ocular problems in daily practice affecting 20% of the general population. A cross-sectional study was conducted during the spring-summer of 2012 to evaluate clinical aspects and therapeutic approach of ocular allergy in Italy.
A total of 3685 patients affected by ocular allergy were enrolled by 304 ophthalmology centers across different geographic regions in Italy. A structured questionnaire was administered to record demographic data, family history, co-morbidities, allergy test results, trigger factors, number of episodes of ocular allergy in the last year. Nine signs and symptoms were scored according the severity, frequency and duration. Patients were divide into 6 clinical forms: SAC, PAC, VKC, AKC, GPC and contact blepharo-conjunctivitis (CBC). Medical treatment in the last year was recorded by drug classes.
Out of 3685 records, 3545 were assessable. The mean age of enrolled patients was 38±19 years (56% female). SAC (55% of patients) and AKC (7%) were equally distributed among the different age groups, while PAC (18%) increased with age and VKC (8%) was more frequent under age of 16. GPC (4%) was more frequent in the group 16-30 year of age. CBC (7%) was more frequent over 45. In the entire population of patients, itching and redness were reported in 94% and 85%, respectively, lid skin involvement in 22% of cases and keratitis in 11%. However, only 35% of patients underwent to an allergy diagnostic evaluation, with positive results in 40% of cases. 68% of the patients reported 1-5 episodes of conjunctivitis in the last year, 6% >10 episodes/year. Considering the entire patients population, over the counter decongestants/ antihistamines were used in 43%, corticosteroids in 41%, topical antihistamines in 29%, systemic antihistamines in 27%, mast cell stabilizers in 15% and antibiotics in 6% of cases. In the SAC group, 26% used systemic antihistamines, 31% topical antihistamines and 44% over the counter decongestants/antihistamines. Corticosteroids were used in 67% of GPC, 55% of VKC, 53% of AKC, 47% of CBC, in 43% of PAC and 28% of SAC.
This survey, based on a simple questionnaire, has provided extremely useful information regarding clinical characteristics, risk factors and treatment options of a large cohort of patients affected by different forms of ocular allergy and stimulates further studies on the clinical evolution and management of these diseases.
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