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Wang H, Jiang X, Zhang P, Li Y, Wang Y, Li X. Allergen-specific IgE in the tear fluid of Chinese patients with common allergic conjunctivitis in autumn and winter. Int Ophthalmol 2023; 43:4541-4549. [PMID: 37668849 DOI: 10.1007/s10792-023-02854-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/05/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE In this study, we determined the positive rates of allergen-specific immunoglobulin E (IgE) in the tear fluid of Chinese patients with common allergic conjunctivitis (AC) in autumn and winter, compared systemic and ocular allergen tests, and explored the correlation between the numbers and categories of allergens and clinical AC features. METHODS This cross-sectional study recruited 44 patients with AC (86 eyes). Specific IgEs for allergens common in China (house dust mite, cat/dog dander, mugwort/ragweed pollen, cottonwood/willow/elm pollen, milk, egg whites, soybeans) were measured in collected tears using kits for allergen-specific IgE antibodies. AC signs and symptoms were graded according to severity. RESULTS Specific IgE in tears was positive in 87.2% of eyes. House dust mite was the most common allergen (86.0%), followed by cat (24.4%) and dog (7.0%) dander; tree and grass pollen accounted for only 4.7% and 2.3%, respectively. Food allergens were not detected. The positive rates of the systemic allergen tests were lower than in tear fluid tests in both eyes, especially for house dust mites (P = 0.000). In patients with more allergens, itching was more severe (P = 0.035), while conjunctival hyperemia was milder (P = 0.002). CONCLUSION In autumn and winter, the most common AC allergen in Chinese patients was house dust mites. Compared with systemic allergen tests, measuring specific IgE in tears may be a non-invasive method to diagnose and evaluate AC severity, which may be more suitable to reflect the local conditions of ocular surface inflammation due to its high positive rate and convenience.
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Affiliation(s)
- Hongmei Wang
- Department of Ophthalmology, Peking University Third Hospital Eye Center, 49 North Garden Rd, Haidian District, Beijing, 100191, People's Republic of China
| | - Xiaodan Jiang
- Department of Ophthalmology, Peking University Third Hospital Eye Center, 49 North Garden Rd, Haidian District, Beijing, 100191, People's Republic of China
| | - Pei Zhang
- Department of Ophthalmology, Peking University Third Hospital Eye Center, 49 North Garden Rd, Haidian District, Beijing, 100191, People's Republic of China
| | - Yingyu Li
- Department of Ophthalmology, Peking University Third Hospital Eye Center, 49 North Garden Rd, Haidian District, Beijing, 100191, People's Republic of China
| | - Yiren Wang
- Department of Ophthalmology, Peking University Third Hospital Eye Center, 49 North Garden Rd, Haidian District, Beijing, 100191, People's Republic of China
| | - Xuemin Li
- Department of Ophthalmology, Peking University Third Hospital Eye Center, 49 North Garden Rd, Haidian District, Beijing, 100191, People's Republic of China.
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Zhao H, Yang Y, Feng C, Wang W, Yang C, Yin Y, Gong L, Lin T. Nonlinear effects of humidex on risk of outpatient visit for allergic conjunctivitis among children and adolescents in Shanghai, China: A time series analysis. J Glob Health 2023; 13:04132. [PMID: 37921044 PMCID: PMC10623378 DOI: 10.7189/jogh.13.04132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023] Open
Abstract
Background Various epidemiological studies have focused on the adverse health outcomes of meteorological factors. However, there has been little research on the impact of humidex on allergic conjunctivitis, especially in child and adolescent populations. We aimed to explore the impact of humidex, a comprehensive index of relative humidity and temperature, on child and adolescent allergic conjunctivitis admissions. Methods Outpatient visit data for allergic conjunctivitis, meteorological factors and air pollutants in Shanghai for the 2017-2022 period were retrieved. For the purpose of analysing the nonlinear connection and lag impact between humidex and admissions for paediatric and adolescent allergic conjunctivitis, the distributed lag nonlinear model (DLNM) was fitted. Results A total of 147 090 cases were included in our cohort. We found a significantly nonlinear effect on humidex and allergic conjunctivitis. In the single-day lag pattern, the relative risks (RR) of allergic conjunctivitis were significant at lag 0 (RR = 1.08, 95% confidence interval (CI) = 1.05-1.11) to lag 2 (RR = 1.01, 95% CI = 1.00-1.01), lag 5 (RR = 1.01, 95% CI = 1.00-1.01) to lag 9 (RR = 1.01, 95% CI = 1.00-1.01), and lag 14 (RR = 1.02, 95% CI: 1.01-1.03). In the cumulative-lag day pattern, the RR of allergic conjunctivitis were significant at lag 0-0 (RR = 1.08, 95% CI = 1.05-1.11) to lag 0-14 (RR = 1.21, 95% CI = 1.13-1.28). We found that boys, children aged 7-17 years, and children in the warm season were more vulnerable to humidex. In addition, the highest attributable fraction (AF) and attributable number (AN) of humidex are at lag 0-14 (AF = 0.17, AN = 25 026). Conclusions Humidex exposure markedly increased the risk of allergic conjunctivitis, especially in highly high humidex. Appropriate public health management is needed for disease management and early intervention.
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Affiliation(s)
- Han Zhao
- Department of Ophthalmology, Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan, China
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | - Yun Yang
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | - Changming Feng
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | - Wushuang Wang
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | - Chenhao Yang
- Department of Ophthalmology, Children's Hospital of Fudan University, Shanghai, China
| | - Yue Yin
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | - Lan Gong
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | - Tong Lin
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
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Fan Z, Yang B, Sun L, Zhang T, Zhang SY, Jin L, Liu Y, Liang L. Effect of Anti-allergic Therapy on Quality of Life in Children with Allergic Conjunctivitis and Their Parents. Ocul Immunol Inflamm 2023; 31:1758-1764. [PMID: 35914318 DOI: 10.1080/09273948.2022.2103830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 07/14/2022] [Indexed: 10/16/2022]
Abstract
PURPOSE To evaluate the effect of anti-allergic therapy on quality of life (QoL) in children with allergic conjunctivitis (AC) and their parents. METHODS Prospective single-arm intervention study including 55 AC child-parent pairs. The endpoint was that AC was successfully controlled after anti-allergic therapies. The primary outcome was the change in QoL of children from baseline to endpoint as measured by the total Pediatric Quality of Life Inventory (PesdQL) score. RESULTS The total PedsQL scores of children and parents were improved after treatment (P < .001). QoL improved greater in children with vernal keratoconjunctivitis/atopic keratoconjunctivitis, those without other allergy outside the eye, and those with lower baseline total PedsQL score. Greater improvement of parents' QoL was associated with longer treating duration, greater improvement of children's QoL, lower baseline parents' total PedsQL score, and more severe baseline children's signs. CONCLUSION Both pediatric AC patients' and their parents 'reduced QoL were improved after anti-allergic therapy. CLINICAL TRIAL REGISTRATION Chinese Clinical Trial Registry Identifier: ChiCTR2000037866.
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Affiliation(s)
- Zixin Fan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Boyu Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Limei Sun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ting Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Shi-Yao Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Lingyi Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
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Balogun MM, Fashola MB. Association between keratoconus and allergic conjunctivitis in children attending a Tertiary Hospital in Nigeria. Rom J Ophthalmol 2023; 67:134-139. [PMID: 37522027 PMCID: PMC10385717 DOI: 10.22336/rjo.2023.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 08/01/2023] Open
Abstract
Objective: To ascertain an association between keratoconus and allergic conjunctivitis and to know if it is necessary to investigate all patients with allergic conjunctivitis for keratoconus. Methods: A hospital-based prospective study in which the eyes of children presenting with ocular allergic diseases were examined. Social demographics and clinical data were captured in a questionnaire. All the patients underwent keratometry using the autorefractor-keratometer and the pachymeter was used to measure the central corneal thickness. Data analysis was done with IBM SPSS version 28 for Windows. Frequency and chi-square were used as descriptive statistics to determine the association between dependent and independent variables. Inferential statistics using one-way ANOVA and t-test. P - Value at <0.05 was considered statistically significant. Results: 121 children with allergic conjunctivitis were reviewed. Males were 72 and females 49. The visual acuity was 6/ 6-6/ 18 in 116, and mild visual impairment - 6/ 18-6/ 60 in 5. The most common complaint was frequent itching in 109 (90.1%). Keratometry was normal in 120 (99.5%), while probable keratoconus was found by keratometry in only one patient (0.5%). Central corneal thickness was within the normal range in 33 (27.3%) children, 43 (35.5%) had thin corneas, while 45 (37.2%) had cornea thickness of more than 560 microns. Discussion: Pediatric keratoconus tends to be more aggressive than adult keratoconus with an increased risk of corneal opacities and subsequent keratoplasty. As a result of these negative impacts, early detection and prompt treatment are mandatory. Conclusion: The prevalence of keratoconus was not found to be high in this study population, but with facts emerging between the association of allergic conjunctivitis, and increased prevalence of keratoconus, it is pertinent to integrate keratoconus screening as part of the management of allergic conjunctivitis using an appropriate tool such as video keratography and slit lamp biomicroscope. Abbreviations: KC = Keratoconus, CLEK = Collaborative Longitudinal Evaluation of Keratoconus, SAC = Seasonal Allergic Conjunctivitis, PAC = Perennial Allergic Conjunctivitis, VKC = Vernal Keratoconjunctivitis, IOP = Intraocular Pressure, CCT = Central Corneal Thickness, TNF-α = Tumor Necrosis Factor-Alpha, IL = Interleukin.
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Affiliation(s)
- Modupe Medina Balogun
- Department of Surgery, Ophthalmology Unit, Lagos State University, College of Medicine, Lagos State, Nigeria
- Department of Ophthalmology, Lagos State University, Teaching Hospital, Lagos State, Nigeria
| | - Maryam Bola Fashola
- Department of Ophthalmology, Lagos State University, Teaching Hospital, Lagos State, Nigeria
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Gao X, Hong L, Xiang Q. A survey of allergic conjunctivitis in children in China. Sci Rep 2022; 12:21026. [PMID: 36470950 PMCID: PMC9722788 DOI: 10.1038/s41598-022-25591-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 12/01/2022] [Indexed: 12/07/2022] Open
Abstract
To explore the risk factors for allergic conjunctivitis (AC) in Chinese children. We recruited 176 children who suffered from AC and a control group comprising 131 normal subjects in southern China. Each participant completed a questionnaire and underwent multiple eye examinations and a skin prick test (SPT). The data of the questionnaire, the scores of the symptoms/signs and the results of the SPT were analysed. The rate of parental allergic history in the case group was much higher than that in the control group (P < 0.01). Compared with the control group, the case group was more likely to have other concomitant diseases (P < 0.01). The scores of ocular symptoms/signs had a significant correlation with the clinical duration of AC in the case group (P < 0.01). Children with other concomitant diseases or a parental allergic history were more likely to have AC.
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Affiliation(s)
- Xu Gao
- Department of Ophthalmology, Bi Shan Hospital of Chongqing, Chongqing, 402700 China
| | - Lan Hong
- Department of Ophthalmology, Bi Shan Hospital of Chongqing, Chongqing, 402700 China
| | - Qin Xiang
- grid.419897.a0000 0004 0369 313XDepartment of Ophthalmology, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014 China ,grid.507984.70000 0004 1764 2990China International Science and Technology Cooperation Basis of Child Development and Critical Disorders, Chongqing, China ,Chongqing Engineering Research Center of Stem Cell Therapy, Chongqing, China
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Ma J, Zhu H, Guo W, Li R, Shen S, Wang Y, Huang D, Zhang X, Fu Z, Zhao A, Chen D, Si J, Zhang J, Xu S, Wang L, Liu H. Association of different digital media experiences with paediatric dry eye in China: a population-based study. BMJ Open 2022; 12:e062850. [PMID: 36450435 PMCID: PMC9717351 DOI: 10.1136/bmjopen-2022-062850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE To investigate the ocular surface effects of different digital media experiences in Chinese elementary school students. DESIGN Population-based cross-sectional study was used. SETTING 14 randomly selected primary schools in Yuhuatai District, Nanjing, China PARTICIPANTS: 2,694 students between 7 and 8-year-old. OUTCOME MEASURES Prevalence of and risk factors for different types of dry eye disease,and different digital media experience with different ocular signs. RESULTS The prevalence of 'symptomatic DED' was 8.7% (95% CI 7.6% to 9.8%) and 'definite DED' prevalence rate was 5.5% (95% CI 4.7% to 6.4%). In multivariable logistic regression model, allergic conjunctivitis (OR=4.33, 95% CI (3.01 to 6.23), p<0.001), more than 1 hour per day on outdoor activity (OR=0.69, 95% CI (0.49 to 0.99), p=0.043), smartphone (OR=2.73, 95% CI (1.51 to 4.91), p=0.001), tablet (OR=2.09, 95% CI (1.07 to 4.07), p=0.030) and homework (OR=1.86, 95% CI (1.22 to 2.83), p=0.004) were independently associated with 'definite DED', while allergic conjunctivitis (OR=5.58, 95% CI (4.12 to 7.55), p<0.001), more than 1 hour per day on outdoor activity (OR=0.72, 95% CI (0.53 to 0.97), p=0.028), smartphone (OR=2.60, 95% CI (1.55 to 4.35), p<0.001), tablet (OR=1.84, 95% CI (1.02 to 3.34), p=0.044) and homework (OR=2.57, 95% CI (1.84 to 3.60), p<0.001) were independently associated with 'symptomatic DED'. CONCLUSIONS Using smartphones or tablets for an average of more than 1 hour per day through the course of a year is independently associated with paediatric DED.
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Affiliation(s)
- Junxin Ma
- Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Ophthalmology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hui Zhu
- Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wei Guo
- Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Rui Li
- Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Shiya Shen
- Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yun Wang
- Pediatrics, Women's Hospital of Nanjing Medical University, Nanjing, China
| | - Dan Huang
- Department of Child Healthcare, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Xiaohan Zhang
- Ophthalmology, Wuxi Children's Hospital, Wuxi, China
| | - Zhujun Fu
- Department of Ophthalmology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Andi Zhao
- Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Danni Chen
- Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jiahao Si
- The Fourth School of Clinical Medicine of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jiyu Zhang
- The Fourth School of Clinical Medicine of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Shasha Xu
- The Fourth School of Clinical Medicine of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Liyuan Wang
- The Fourth School of Clinical Medicine of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hu Liu
- Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Chen M, Ke B, Zou J, Gong L, Wang Y, Zhang C, Xu J, Wei A, Hong J. Combination Therapy of 0.1% Fluorometholone and 0.05% Azelastine in Eyes with Severe Allergic Conjunctival Diseases: A Randomized Controlled Trial. J Clin Med 2022; 11:jcm11133877. [PMID: 35807160 PMCID: PMC9267215 DOI: 10.3390/jcm11133877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/26/2022] [Accepted: 06/30/2022] [Indexed: 02/01/2023] Open
Abstract
This study sought to evaluate the efficacy of the isolated use of fluorometholone compared with the combined use of azelastine and fluorometholone for the treatment of severe allergic conjunctival disease (ACD). One hundred and eleven patients with severe ACD were randomized into two groups: one treated with topical 0.1% fluorometholone combined with 0.05% azelastine and the other with 0.1% fluorometholone alone. The Ocular Surface Disease Index (OSDI) and the signs of keratopathy, palpebral conjunctiva papillae and conjunctival congestion were scored before and at one, two and six weeks after treatment and compared between the groups. The intra-ocular pressure (IOP) was also monitored. There were no significant differences between the groups in the baseline mean scores of signs and OSDI scores, which gradually improved at all visits after therapy in both groups. Although the time effect was significant for all the parameters (all p < 0.001), the reduction in corneal involvement scores from week 2 to week 6 was insignificant in both groups (p = 0.460 for the steroids group and p = 0.074 for the combination group). All signs and symptoms were significantly more improved in the combination group than in the isolated group at each control visit. IOP remained stable at all visits (all p < 0.001), except one patient in each group had elevated IOP over 21 mmHg. While both the isolated use of fluorometholone and combined use of azelastine and fluorometholone are effective in alleviating the signs and symptoms of severe ACD, optimal response can be achieved with adjunctive treatment including azelastine.
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Affiliation(s)
- Minjie Chen
- Department of Ophthalmology, Eye and Ear, Nose, Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China; (M.C.); (L.G.); (Y.W.); (C.Z.); (J.X.)
- Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, 83 Fenyang Road, Shanghai 200031, China
- Key Myopia Laboratory of National Health Commission of China, 83 Fenyang Road, Shanghai 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, 83 Fenyang Road, Shanghai 200031, China
| | - Bilian Ke
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, China;
| | - Jun Zou
- Department of Ophthalmology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, China;
| | - Lan Gong
- Department of Ophthalmology, Eye and Ear, Nose, Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China; (M.C.); (L.G.); (Y.W.); (C.Z.); (J.X.)
- Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, 83 Fenyang Road, Shanghai 200031, China
- Key Myopia Laboratory of National Health Commission of China, 83 Fenyang Road, Shanghai 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, 83 Fenyang Road, Shanghai 200031, China
| | - Yan Wang
- Department of Ophthalmology, Eye and Ear, Nose, Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China; (M.C.); (L.G.); (Y.W.); (C.Z.); (J.X.)
- Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, 83 Fenyang Road, Shanghai 200031, China
- Key Myopia Laboratory of National Health Commission of China, 83 Fenyang Road, Shanghai 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, 83 Fenyang Road, Shanghai 200031, China
| | - Chaoran Zhang
- Department of Ophthalmology, Eye and Ear, Nose, Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China; (M.C.); (L.G.); (Y.W.); (C.Z.); (J.X.)
- Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, 83 Fenyang Road, Shanghai 200031, China
- Key Myopia Laboratory of National Health Commission of China, 83 Fenyang Road, Shanghai 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, 83 Fenyang Road, Shanghai 200031, China
| | - Jianjiang Xu
- Department of Ophthalmology, Eye and Ear, Nose, Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China; (M.C.); (L.G.); (Y.W.); (C.Z.); (J.X.)
- Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, 83 Fenyang Road, Shanghai 200031, China
- Key Myopia Laboratory of National Health Commission of China, 83 Fenyang Road, Shanghai 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, 83 Fenyang Road, Shanghai 200031, China
| | - Anji Wei
- Department of Ophthalmology, Eye and Ear, Nose, Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China; (M.C.); (L.G.); (Y.W.); (C.Z.); (J.X.)
- Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, 83 Fenyang Road, Shanghai 200031, China
- Key Myopia Laboratory of National Health Commission of China, 83 Fenyang Road, Shanghai 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, 83 Fenyang Road, Shanghai 200031, China
- Correspondence: (A.W.); (J.H.); Tel.: +86-21-64377134 (A.W. & J.H.); Fax: +86-21-64318258 (A.W. & J.H.)
| | - Jiaxu Hong
- Department of Ophthalmology, Eye and Ear, Nose, Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China; (M.C.); (L.G.); (Y.W.); (C.Z.); (J.X.)
- Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, 28 Guiyi Road, Guiyang 550031, China
- Correspondence: (A.W.); (J.H.); Tel.: +86-21-64377134 (A.W. & J.H.); Fax: +86-21-64318258 (A.W. & J.H.)
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Chen D, Li R, Huang D, Tong H, Zhao X, Yan W, Shen S, Liu H, Zhu H. Altered retinal nerve fiber layer thickness in children with allergic conjunctivitis: the Nanjing eye study. BMC Ophthalmol 2022; 22:183. [PMID: 35459115 PMCID: PMC9028092 DOI: 10.1186/s12886-022-02399-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 04/12/2022] [Indexed: 11/16/2022] Open
Abstract
Background So far, few data are available on the relationship between allergic conjunctivitis (AC) and ocular fundus. Whether retinal parameters change in patients with AC remains unknown. In this study, we investigated the influence of AC on retinal thickness and vessel density among 7-years-old school-age children. Methods This large population-based study is part of the Nanjing Eye Study (NES). Comprehensive examinations including anthropometric parameters, refraction, ocular biometric parameters, intraocular pressure and retinal parameters were conducted on each child. Retinal thickness and vessel density were assessed using the optical coherence tomography angiography. Information on AC was obtained from a comprehensive questionnaire. Results A total of 739 children (mean age ± SD: 7.40 ± 0.29 years) had complete eye examination and questionnaire data we needed. Ninety-four children (12.7%) had AC, among which, 5 children had the history of corticosteroid use and were excluded from the final analysis. Spherical equivalent, axial length, body mass index and birth weight were correlated with retinal parameters. After adjusting for sex, age, spherical equivalent, axial length, body mass index, birth weight and premature history, children with AC had thinner retinal nerve fiber layer thickness for average (117.39 versus 120.97 μm, p = 0.007), temporal (80.73 versus 84.34 μm, p = 0.001), nasal (98.82 versus 102.18 μm, p = 0.049) and inferior (152.68 versus 157.06 μm, p = 0.034) quadrants than the control group. Conclusions Children with AC tended to have thinner retinal nerve fiber layer thickness. More attention is needed to fundus condition of children with AC. Supplementary information The online version contains supplementary material available at 10.1186/s12886-022-02399-7.
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Affiliation(s)
- Danni Chen
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Rui Li
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Dan Huang
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Haohai Tong
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Eye Center, Hangzhou, Zhejiang, China
| | - Xiaoyan Zhao
- Department of Ophthalmology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, 213164, Jiangsu Province, P.R. China
| | - Wen Yan
- Department of Ophthalmology, The Fourth Affiliated Hospital of Nantong University, The First people's Hospital of Yancheng, Yancheng, China
| | - Shiya Shen
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
| | - Hui Zhu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
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Morphological and Functional Changes of Meibomian Glands in Pediatric and Adult Patients with Allergic Conjunctivitis. J Clin Med 2022; 11:jcm11051427. [PMID: 35268518 PMCID: PMC8911235 DOI: 10.3390/jcm11051427] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/21/2022] [Accepted: 03/01/2022] [Indexed: 11/16/2022] Open
Abstract
Allergic conjunctivitis (AC) is one of the most common ocular disorders in clinical practice and is associated with meibomian gland dysfunction. This study aimed to explore the morphological and functional changes of meibomian glands (MGs) in pediatric and adult patients with AC and to analyze their potential predictors. In our prospective, observational cohort study, a total of 59 patients with AC were enrolled, with 30 patients aged ≤16 years in the pediatric group and 29 patients in the adult group. All patients underwent examinations at baseline and last visit when the complete resolution of conjunctival papillae was identified. An automatic MG analyzer was used to measure the morphological and functional parameters of MGs, including their area ratio (GA), tortuosity index (TI), and signal index (SI). Two groups were comparable at baseline in terms of characteristics and MG parameters (p > 0.05). The morphological (length, square, and GA) and functional MG parameters (SI) of AC patients significantly improved in the pediatric group after treatment (all p < 0.05), but not in the adult group. The change in the GA correlated with age, sex, GA, TI, and SI at baseline (all p < 0.05). Age (p = 0.001) and GA (p < 0.001) at baseline were predictors of an improvement in the GA of MGs. The findings showed that the structure and function of MGs in pediatric patients with AC seem to improve after the conjunctival papillae disappear, but not in adult patients.
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Lu CW, Fu J, Liu XF, Chen WW, Hao JL, Li XL, Pant OP. Air pollution and meteorological conditions significantly contribute to the worsening of allergic conjunctivitis: a regional 20-city, 5-year study in Northeast China. LIGHT, SCIENCE & APPLICATIONS 2021; 10:190. [PMID: 34535628 PMCID: PMC8448737 DOI: 10.1038/s41377-021-00630-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/25/2021] [Accepted: 09/02/2021] [Indexed: 05/19/2023]
Abstract
This study is the first to explore the potential associations among allergic conjunctivitis (AC), air pollution, and meteorological conditions in Northeast China. Data of meteorology, ambient atmospheric pollutants, and the incidence of allergic conjunctivitis (IAC) in prefecture-level cities between the years 2014 and 2018 are analyzed. The results show an increasing trend in the AC of average growth rate per annum 7.6%, with the highest incidence in the provincial capitals. The IAC is positively correlated with atmospheric pollutants (i.e., PM2.5, PM10, CO, SO2, NO2, and O3) and meteorological factors (i.e., air temperature and wind speed), but negatively correlated with relative humidity. These results suggest that the IAC is directly proportional to pollution level and climatic conditions, and also the precedence of air pollution. We have further obtained the threshold values of atmospheric pollutants concentration and meteorological factors, a turning point above which more AC may be induced. Compared with the air quality standard advised by China and the World Health Organization (WHO), both thresholds of PM10 (70 μg m-3) and PM2.5 (45 μg m-3) are higher than current standards and pose a less environmental risk for the IAC. SO2 threshold (23 μg m-3) is comparable to the WHO standard and significantly lower than that of China's, indicating greater environmental risks in China. Both thresholds of NO2 (27 μg m-3) and O3 (88 μg m-3) are below current standards, indicating that they are major environmental risk factors for the IAC. Our findings highlight the importance of atmospheric environmental protection and reference for health-based amendment.
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Affiliation(s)
- Cheng-Wei Lu
- The Department of Ophthalmology, The First Hospital of Jilin University, Changchun, 130021, China.
| | - Jing Fu
- Key Laboratory of Wetland Ecology and Environment, Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Changchun, 130102, China
| | - Xiu-Fen Liu
- The Department of Ophthalmology, The First Hospital of Jilin University, Changchun, 130021, China
| | - Wei-Wei Chen
- Key Laboratory of Wetland Ecology and Environment, Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Changchun, 130102, China.
| | - Ji-Long Hao
- The Department of Ophthalmology, The First Hospital of Jilin University, Changchun, 130021, China
| | - Xiao-Lan Li
- Institute of Atmospheric Environment, China Meteorological Administration, Shenyang, 110166, China
| | - Om Prakash Pant
- Dhangadhi Netralaya Eye Hospital, Dhangadhi, 3, Kailali, Nepal
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11
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Li C, Chen Q, Zhang X, Li H, Liu Q, Fei P, Huang L, Yao Z. Early Life Domestic Pet Ownership, and the Risk of Pet Sensitization and Atopic Dermatitis in Preschool Children: A Prospective Birth Cohort in Shanghai. Front Pediatr 2020; 8:192. [PMID: 32391295 PMCID: PMC7193020 DOI: 10.3389/fped.2020.00192] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 03/31/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Although domestic pet ownership is on the rise, the impact of early life pet ownership on children's pet sensitization and atopic dermatitis (AD) remains controversial. Methods: Shanghai Allergy Cohort is an ongoing prospective study followed up to the age of 5 years. Pregnant mothers were recruited and their offspring were followed up every year by a group of pediatricians. Information on furred pet ownership was collected by the questionnaire. AD was diagnosed by dermatologists according to disease history and Williams criteria at 5 years ± 1 months. Skin prick test (SPT) was performed to determine sensitization to specific allergens. Multiple logistic regression models were used to evaluate the associations between pet ownership and AD, dog/cat sensitization. Results: In the 538 children at preschool age, 112 (20.82%) were diagnosed with AD. Dermatophagoides pteronyssinus and Dermatophagoides farina were the most common allergens, and almost 10% of children were positive to dog and cat. The percentage of positive SPT reactors at 5-year old was 65.28% in the group of children with AD, higher than that in non-AD group (44.57%). Domestic pet ownership at both infant and preschool period was positively associated with an increased risk of sensitization to dog (OR adjusted = 2.85 [95% CI: 1.08-7.50 for infant exposure], OR adjusted = 2.73 [95% CI: 1.33-5.61] for preschool exposure), and interestingly, pet ownership at infant period negatively associated with higher risk of AD at 5-year old (OR adjusted = 0.33 [95% CI: 0.12-0.88]). Conclusion: This is the first prospective birth cohort study in Shanghai that found half of preschool children had positive allergen sensitization even in the non-AD children. Although early life exposure to dog may increase the risk of dog sensitization, it significantly decreased the risk of AD. The underlying mechanisms warrant further investigations.
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Affiliation(s)
- Chunxiao Li
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Institute of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Chen
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xi Zhang
- Clinical Research Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huaguo Li
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Institute of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Quanhua Liu
- Department of Pediatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ping Fei
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lisu Huang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Pediatrics Infectious Diseases, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhirong Yao
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Institute of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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12
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Fauquert JL. Diagnosing and managing allergic conjunctivitis in childhood: The allergist's perspective. Pediatr Allergy Immunol 2019; 30:405-414. [PMID: 30742722 DOI: 10.1111/pai.13035] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/23/2019] [Accepted: 01/24/2019] [Indexed: 12/26/2022]
Abstract
Allergic conjunctivitis in childhood often poses problems of diagnosis and management for the allergist. We present the salient points concerning the diagnosis and treatment of ocular allergy emerging from a large cohort survey conducted jointly in the departments of ophthalmology and paediatric allergy in a French teaching hospital. Seasonal acute conjunctivitis is a common disorder and not overly difficult to diagnose and treat when associated with rhinitis leading to allergic rhinoconjunctivitis. An ophthalmologist should be consulted when conjunctivitis occurs alone and if another form of conjunctivitis is suspected, such as perennial allergic conjunctivitis, vernal keratoconjunctivitis or atopic keratoconjunctivitis. When IgE-mediated hypersensitivity assessment does not establish aetiological diagnosis, a conjunctival allergen provocation test can be performed. The principal non-IgE-mediated allergy is chronic blepharoconjunctivitis. The main problem for differential diagnosis is the presence of signs suggestive of dry eye. Management includes non-pharmacological treatments, such as lacrimal substitutes, avoidance measures and protection of the ocular surface. Second-line treatment consists of eye drops, preferably single dose or without additives and with dual local action, mast cell stabilizer action and antihistaminic action. Third-line treatment is reserved for severe forms. Short-lasting local steroid therapy can control flare-ups of allergic keratoconjunctivitis, which should have specialized follow-up. Cyclosporine is a disease-modifying treatment, which is both effective and well tolerated.
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Affiliation(s)
- Jean-Luc Fauquert
- CHU Clermont-Ferrand, Consultation d'Ophtalmologie et Allergologie de l'enfant, Unité d'Allergologie de l'enfant, CHU Estaing, Clermont-Ferrand Cedex1, France
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