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H. d. Bezerra, M. D. Capriglione, J. R. Zorrilla Neto, J. F. Sarmento; Trachoma in Patients With Allergic Conjunctivitis. Invest. Ophthalmol. Vis. Sci. 2008;49(13):415.
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The aim of this paper was to identify possible association between allergic conjunctivitis and Chlamydia trachomatis infection.
A prospective study was performed in hundred four eyes of fifty two patients with diagnosis of vernal conjunctivitis and atopic keratoconjunctivitis. Conjunctival cytology was performed, because it represents an important diagnosis method, once it may show the existence of eosinophils and inclusions corpuscles in the smear of the conjunctival scraping. Direct immunofluorescence was performed in all the fifty two patients in order to identify differential diagnosis or a possible association between the allergic conjunctivitis and Chlamydia trachomatis infections. All procedures were approved by the Ethics Committee in Research. Level of rejection of the nullity hypothesis was set in 0,05 or 5% (<0,05).
Of the 52 patients, 41 (78,8%) presented vernal conjunctivitis and 11 (21,2%) atopic keratoconjunctivitis. Forty one (78,8%) were male and 11 (21,2%) were female. The ages varied from 3 to 19 years, with a 9,8 year-old average. As for the ethnic distribution, sixteen (30,8%) patients were white, fourteen (26,9%) were black and twenty-two (42,3%) were mestizo. Patient with systemic allergic disease it was observed that twenty-five (48,1%) patients presented bronchial asthma, twenty (38,5%) allergic rhinitis and five (9,6%) atopic dermatitis. The main symptoms complained by patients were coryza (59,6%), ocular itching (98,1%), burning (61,5%), tearing (65,3%) and photophobia (61,5%). The main clinical signs were: ocular hiperemia (100%), bilaterality (100%), superior tarsal papilla (92,3%) and mucous secretion (82,7%). Eosinophil is the main cell involved in the diagnosis of the ocular allergy evidenced through the cytology of the conjunctival scrapings, the eosinophil was found in 86,5% of the cases. Only seven patients didn't present eosinophils in the conjunctival scrapings. We observed that 3 patients (5,8%) presented positive immunofluorescence for Chlamydia, which verified an association between allergic conjunctivitis and trachoma. The direct immunofluorescence is the choice exam for confirmation of Chlamydia trachomatis infections.
It is important to determine the simultaneous existence of allergic conjunctivitis and trachoma. First of all: trachoma can progress to blindness, a disabling disease. Second: it can change visual prognosis of conjunctivitis, therefore it is necessary to perform the direct immunofluorescence for the diagnosis of Chlamydia trachomatis in patients with allergic conjunctivitis.
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