Abstract
Purpose :
To evaluate visual outcome, rate of complications and strength of required treatment in patients with different grades of atopic keratoconjunctivitis.
Methods :
We reviewed patients’ charts from 2005 to 2018. Patients with atopic conjunctivitis were divided into 2 groups: patients without history of irreversible corneal or conjunctival changes (group 1, n=14), patients with history of irreversible corneal and/or conjunctival changes (group 2, n=16). Patients with concomitant ocular cicatricial pemphigoid (OCP) were excluded from the study. We assessed visual acuity, whether control of symptoms was achieved, treatment, and complications rates by the end of follow up period. Independent sample T-test, Chi square statistics and Mann-Whitney U test were used for statistical analysis.
Results :
Mean age in group A was 55 (SD11) years, in group B was 49 (SD21) years. Follow up period and time from disease onset in group A were 43 (range, 5-151) months and 92 (range, 8-162) months respectively, in group B were 75 (range, 4-160) and 130 (range, 11-262) months respectively. Groups were statistically equal by age (p=0.39), gender (p=0.21) and follow up period (p=0.13), but differed by duration from the disease onset (p=0.05). Average visual acuity change through follow up period in group A was 0.07 (range 0-2.28) logMAR and in group B was 0.13 (range -0.45-2.7) logMAR, p=0.14. Vision acuity was different between the two groups in the beginning (p=0.001) and by the end of study (p=0.009). 11 patients (79%) from group A and 9 patients (56%) from group B reported significant symptomatic improvement, difference was not statistically significant (p=0.20). Therapy between the two groups differed significantly for use of oral cyclosporine only (p=0.02). Use of topical cyclosporine, topical and oral antihistamines, topical and oral steroids and topical mast cell stabilizers were not significantly different between the groups. Patients from group B had steroid induced glaucoma (p=0.05) more frequently, whereas keratoconus (p=0.17) and herpes keratitis (p=0.09) were not significantly different between the two groups.
Conclusions :
We found that atopic keratoconjunctivitis patients with scarring of cornea or conjunctiva at presentation required use of oral cyclosporine more frequently and developed steroid induced glaucoma more frequently.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.