Vernal keratoconjunctivitis-like disease in adults.
OBJECTIVE
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).


METHODS
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.
Ophthalmology Unit, Department of Neuroscience, University of Padua, Padua, Italy. andrea.leonardi@unipd.it
Andrea
A
Leonardi
Daniela
D
Lazzarini
Laura
L
Motterle
Massimo
M
Bortolotti
Velika
V
Deligianni
S John
SJ
Curnow
Stefano
S
Bonini
Iva A
IA
Fregona
D000328:Adult; D003233:Conjunctivitis, Allergic / Q000453:epidemiology* / Q000276:immunology; D003315:Cornea / Q000276:immunology* / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis*; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000276:immunology*; D013666:Tears / Q000737:chemistry* / Q000276:immunology; D055815:Young Adult
D016207:Cytokines; D007073:Immunoglobulin E