Unpacking VKC: How gender and age shape the clinical picture

Area of Science:

• Ophthalmology
• Allergic Eye Diseases

Background:

• Vernal keratoconjunctivitis (VKC) is a bilateral, itching, and inflammatory ocular surface disease.
• VKC typically affects children and adolescents, but adult-onset cases are increasingly recognized.

Purpose of the Study:

• To investigate gender differences in childhood-onset VKC (C-VKC) and adult-onset VKC (A-VKC).
• To compare clinical variations between C-VKC and A-VKC patient groups.

Main Methods:

• Retrospective observational study of 1018 VKC patients from January 2015 to December 2020.
• Patients were categorized by age of onset: <16 years (C-VKC) and >16 years (A-VKC).
• Analysis included gender, family history, comorbidities, VKC variant, severity, and complications.

Main Results:

• Male predominance was observed in both C-VKC and A-VKC, with a slightly lower proportion in A-VKC.
• Asthma was more common in C-VKC, while skin allergies were more prevalent in A-VKC.
• Limbal stem cell deficiency was significantly higher in A-VKC, while C-VKC showed more multiple complications and surgical interventions.

Conclusions:

• Adult-onset VKC is a distinct entity with a generally milder clinical course than C-VKC.
• No significant gender-based differences were found in the clinical presentation or complications of A-VKC.
• Limbal stem cell deficiency is a notable complication in A-VKC, irrespective of gender.