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Perilimbal conjunctival pigmentation in Chinese patients with vernal keratoconjunctivitis
F O J Luk1, V W Y Wong, S K Rao
1Department of Ophthalmology & Visual Science, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China.
Insights
Perilimbal conjunctival pigmentation is a consistent finding in Chinese children with vernal keratoconjunctivitis (VKC). This sign may aid in diagnosing VKC, especially in cases with subtle symptoms.
Area of Science:
- Ophthalmology
- Clinical Research
Background:
- Vernal keratoconjunctivitis (VKC) is a bilateral, itching, seasonal eye inflammation.
- Diagnosis of VKC can be challenging, particularly in early stages or with subtle presentations.
Purpose of the Study:
- To document the disease spectrum of VKC in Chinese patients.
- To evaluate the presence and diagnostic utility of perilimbal conjunctival pigmentation in Chinese patients with VKC.
Main Methods:
- A case-control study compared 19 Chinese children with VKC to 23 age-matched controls.
- Detailed slit-lamp examinations assessed papillary reaction, corneal complications, and perilimbal conjunctival pigmentation.
Main Results:
- All VKC patients exhibited perilimbal conjunctival pigmentation, with significant correlation in color and density between eyes.
- Controls did not show this pigmentation (P<0.001).
- Bilateral papillae and epithelial defects correlated with symptom severity (P=0.015, P=0.035).
Conclusions:
- Perilimbal conjunctival pigmentation is a consistent clinical finding in Chinese patients with VKC.
- This pigmentation may serve as a valuable diagnostic marker for VKC, especially in ambiguous cases.
Purpose:
To document the disease spectrum and evaluate the presence of perilimbal conjunctival pigmentation in Chinese patients with vernal keratoconjunctivitis (VKC).
Method:
A case-control study was conducted between November 2004 and July 2005. Patients aged 18 or younger with VKC and age-matched children attending our eye clinic for refractive or orthoptic problems were recruited and compared. Detailed slit-lamp examination was performed noting in particular the presence of perilimbal conjunctival pigmentation, the severity of papillary reaction, and corneal complications of VKC.
Results:
A total of 19 patients and 23 controls were evaluated. The presence of bilateral large tarsal or limbal papillae and epithelial defect were significantly associated with symptoms severity (Fisher's exact test, P=0.015 and P=0.035 respectively). All VKC patients were found to have perilimbal conjunctival pigmentation in at least one eye. There was a significant correlation in the colour and density of pigments between the two eyes (Sperman's rho=0.93, P<0.001). None of the controls was found to have such perilimbal conjunctival pigmentation (Fisher's exact test, P<0.001).
Conclusion:
The presence of perilimbal conjunctival pigmentation appears to be a consistent clinical finding in Chinese patients with VKC and may be a useful diagnostic sign for patients with subtle signs or symptoms.
