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Clinical characteristics and outcomes of ocular allergy in Thai children
Rasamee Jongvanitpak1, Pakit Vichyanond1, Orathai Jirapongsananuruk1
1Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Insights
Perennial allergic conjunctivitis is common in Thai children, often linked to house-dust mites. Topical calcineurin inhibitors effectively reduce corticosteroid use in severe allergic conjunctivitis cases.
Area of Science:
- Ophthalmology
- Allergy Immunology
- Pediatrics
Background:
- Allergic conjunctivitis (AC) is a prevalent ocular condition in allergic children.
- Research on clinical features and treatment outcomes of childhood AC in tropical regions is limited.
Purpose of the Study:
- To investigate the clinical characteristics of ocular allergy in children.
- To evaluate the treatment outcomes for various types of allergic conjunctivitis in pediatric patients.
Main Methods:
- Children with a history of AC were categorized into seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), vernal keratoconjunctivitis (VKC), and atopic keratoconjunctivitis (AKC).
- Clinical history and treatment outcomes were systematically recorded for all participants.
Main Results:
- 164 children were studied; PAC was most common (61.6%), followed by SAC (21.3%), VKC (12.2%), and AKC (4.9%).
- Allergic rhinitis (97.6%) was a frequent comorbidity, with house-dust mites identified as the primary allergen (86.1%).
- Topical tacrolimus enabled discontinuation of topical corticosteroids in VKC and AKC patients, achieving 35% and 63% remission, respectively.
Conclusions:
- House-dust mites are the main allergen for Thai children with AC.
- Severe AC forms often require add-on medications.
- Topical calcineurin inhibitors serve as effective add-on therapies, reducing reliance on topical corticosteroids.
Background:
Allergic conjunctivitis (AC) is the most common ocular condition in allergic children. In tropical countries, the study about the clinical features and outcome of treatment is very limited.
Objective:
To review clinical characteristics and outcomes of treatment in children with ocular allergy.
Methods:
Children with history of AC were classified to seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC). The clinical history and outcome of treatment were recorded.
Results:
One hundred and sixty-four children were recruited. PAC was the most common type (61.6%), followed by SAC (21.3%), VKC (12.2%), and AKC (4.9%). Male preponderance was found in all groups. Mean age of onset was 6.8 ± 2.8 years. Allergic rhinitis was the most common co-morbidity (97.6%). The common sensitized allergen is house-dust mites (86.1%). Standard treatments in all groups were natural tear and topical olopatadine. Add-on medications were usually needed in severe types of AC (VKC, AKC). History of topical corticosteroid use was 68.8% and 12.5% in VKC and AKC, respectively. All of them can discontinue topical corticosteroid when topical tacrolimus was applied. The overall remission was found 35% in VKC group and 63% in AKC group. The median duration of treatment was 20.5 months in VKC group and 11 months in AKC group.
Conclusions:
most Thai children with AC sensitized to house-dust mites. In severe forms of AC, most patients needed addon medication. The use of topical calcineurin inhibitor as an add-on therapy can decrease the use of topical corticosteroid.
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