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J. Y. Huang, E. Uchio, K. Kadonosono; The Epidemiology and the Evaluation of the New Criteria for Clinical Assessment in Allergic Ocular Diseases. Invest. Ophthalmol. Vis. Sci. 2008;49(13):421.
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Allergic ocular diseases (AOD) are characterized by their wide variety of clinical features. Criteria for clinical evaluation is essential for objective assessment in clinical trials and for clinical studies on the etiology of AOD. An international criteria for clinical evaluation and classification of the severity of AOD has not been established so far. We here established a new criteria and applied it to AOD patients and evaluated its usefulness for clinical purposes. We also studied whether each clinical entity of AOD; allergic conjunctivitis (AC), atopic keratoconjunctivitis (AKC), and vernal keratoconjunctivitis (VKC), can be distinguished by the new criteria.
A prospective study was carried out to assess the differential diagnosis of 1079 patients with AOD (439 male and 640 female patients). Differential diagnosis of AC, AKC or VKC was made. The diseases were diagnosed and classified based on local and systemic clinical findings. Ten objective ocular clinical findings of conjunctival, limbal, and corneal lesions were graded each on a 4-point scale. The total score, with a highest value of 30, determines the clinical score.
Among a total of 1079 cases, seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), AKC and VKC accounted for 876 (81.2%), 115 (10.6%), 47 (4.4%) and 41 (3.8%), respectively. The mean age in each disease was 52.9, 56.1, 25.7 and 16.6 years, respectively. Total clinical score in SAC, PAC, AKC and VKC was 1.54, 2.13, 3.72 and 12.68, respectively. Both mean age and the total clinical score in all combinations of two diseases showed significantly different results.
These results suggest that AOD can be classified by our new clinical grading system, and this system is practical for clinical evaluation of AOD. Re-evaluation of AOD is essential for constructing future strategies for the treatment of AOD, which consists of various categories of ocular disorders.
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