Abstract
Purpose: :
The aim of the study was to evaluate the prevalence of systemic atopy and immunoglobulin (Ig) deficiencies in Turkish patients with vernal keratoconjunctivitis (VKC). We also investigated the association of serum IgE levels with VKC subtypes and keratoconus detected by corneal topography.
Methods: :
Blood samples were collected for the determination of peripheral blood eosinophil counts (PBEC), serum Ig levels and specific IgE levels for common allergens. Allergen sensitivity was also tested with skin prick tests. Corneal topography was performed using a rotating Scheimpflug camera (Pentacam, Oculus, Wetzlar, Germany).
Results: :
Among 67 subjects, 53 (79.1%) were boys with a mean age of 11.3±4.3 years (5-26 years). There were 11 limbal (16.4%), 28 tarsal (41.8%) and 28 mixed type (41.8%) VKC subjects. Family history of atopy and co-associated rhinitis/asthma/dermatitis were detected in 35.5% and 32.8/1.5/6% of the subjects, respectively. Blood eosinophilia (PBEC ≥ 400/μl), elevated serum total IgE, serum specific IgE, positive skin tests and keratoconus were detected in 33.8%, 42.2% 42.1%, 33.3% and 40% of the subjects, respectively, with no differences among clinical subtypes of VKC (p>0.05). The prevalence of keratoconus was higher in subjects with increased IgE levels (55.6%) compared to subjects with normal IgE levels (30.6%) (p=0.046). Serum IgE levels of VKC subjects with keratoconus was higher compared to subjects without (129 and 58.6 kU/L, respectively) (p=0.18). Low levels of IgA, IgG and IgM were detected in 6 (9.7%), 4 (6.5%) and 2 (3.2%) patients, respectively.
Conclusions: :
Systemic atopy is associated with VKC in approximately 40% of the cases and the prevalence of Ig deficiency is high compared to general population. Therefore, ophthalmologists should consult these patients with allergists/immunologists.
Keywords: conjunctivitis • cornea: clinical science • keratoconus