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Edoardo Villani, Lorenzo Caminada, Marika Dello Strologo, Claudia Mainetti, Francesco Viola, Paolo Nucci; The ocular surface in parents of VKC children reporting a history of presumed VKC during their childhood. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2950.
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© ARVO (1962-2015); The Authors (2016-present)
To identify parents of children with vernal keratoconjunctivitis (VKC) who report a history of presumed VKC in their childhood (P-PPVKC) and to analyze their ocular surface.
We consecutively interviewed, in a standardized manner, 262 parents of 131 children affected by VKC. We identified 28 P-PPVKC, reporting previous diagnosis of VKC OR childhood chronic/recurrent severe ocular surface inflammation, requiring frequent use of topical steroids, healed after puberty.The same questions, proposed to 262 parents of 131 children without VKC, allowed us to identify 3 subjects reporting this type of medical history.We analyzed the ocular surface of the 28 P-PPVKC (44.2±6.5 years old, 15 males), and we compared them with 28 age- and sex- matched control parents of VKC children not reporting this type of medical history (P-NPVKC). Exclusion criteria were ocular or systemic co-morbidities and therapies with known effect on the ocular surface.We performed a masked exam including ocular surface disease index (OSDI), tear film meniscometry, fluorescein break-up time, ocular surface staining, lid parallel conjunctival folds and tarsal fibrosis assessment, Meibomian glands expressibility, corneal apex sensitivity, Schirmer test without anesthesia, and corneal in vivo confocal microscopy. Confocal parameters included basal epithelial cells density, subbasal nerve plexus fiber length density, fiber density, number of branches (NBD, number/mm2), number of beadings, and fiber tortuosity (FT).
28/131 (21%) of children with VKC had one P-PPVKC (vs. 2% of children without VKC).P-PPVKC subjects, compared with P-NPVKC, showed higher OSDI score (9.0±7.98 vs 3.73±2.96; P< 0.01, t-test) and higher ocular surface staining (Oxford score >0: 64% vs 29%, P<0.01, Chi-square test).Confocal data showed, in P-PPVKC subjects, higher basal epithelial cells density (6472.27±804.45 vs 5985.14±638.73 cells/mm2; P<0.05, t-test), higher NBD (88.34±44.67 vs 64.69±7.97; P<0.05, Mann-Whitney U test), and increased FT (2.65±0.59 vs 1.64±0.41; P<0.05, Mann-Whitney U test).
Our data suggested that VKC might have a strong hereditary component. Moreover, although it generally resolves spontaneously after puberty, VKC might induce long-term slight ocular surface changes, whose potential to increase the risk of dry eye or other ocular surface diseases should be investigated.
This is a 2020 ARVO Annual Meeting abstract.
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