Vernal Keratoconjunctivitis-like Disease in Adults

• Published in: American journal of ophthalmology 2013-05, Vol.155 (5), p.796-803
• Main Authors: Leonardi, Andrea, Lazzarini, Daniela, Motterle, Laura, Bortolotti, Massimo, Deligianni, Velika, Curnow, S. John, Bonini, Stefano, Fregona, Iva A
• Format: Article
• Language: English
• Subjects: Adult; Age; Allergies; Conjunctivitis, Allergic - epidemiology; Conjunctivitis, Allergic - immunology; Cornea - immunology; Cornea - metabolism; Cytokines; Cytokines - metabolism; Disease; Family medical history; Female; Follow-Up Studies; Humans; Immunoglobulin E - analysis; Incidence; Italy - epidemiology; Male; Ophthalmology; Prognosis; Quality of Life; Retrospective Studies; T-Lymphocytes - immunology; Tears - chemistry; Tears - immunology; Ulcers; Young Adult; Young adults
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2012.11.018

Purpose To identify clinical, demographic, immunologic, and health-related quality-of-life data from a cohort of vernal keratoconjunctivitis (VKC) patients with the onset of the disease after puberty (VKC-like disease). Design Retrospective, observational case series. Methods Forty-nine patients with late-onset VKC-like disease from among 600 consecutive VKC patients. History of disease, test results for allergen sensitivity, signs and symptoms, impact of disease on work productivity, health-related quality of life, and treatment satisfaction were assessed. In addition, multiplex bead analysis for Th1/Th2 cytokines were carried out in tear samples from 20 VKC patients (10 adults and 10 children) and from 10 normal subjects. Results A family history of allergy was positive in only 28% and positive prick test results were present in 55% of the 49 VKC-like adult patients. Based on typical signs and symptoms, 48% were affected by the limbal form, 33% were affected by the tarsal form, and 19% were affected by the mixed form. Corneal ulcer complicated the disease in only 2 adult patients. Although the disease was not considered a limiting factor for work, productivity was reduced by 26% and social activities were reduced by 31% during active flare-ups. No significant differences were found in tear cytokine pattern production between VKC in children and VKC in adults. Conclusions A late onset VKC-like disease can appear in young adults with signs and symptoms similar to those in pediatric disease, but with less corneal involvement.