Analyses On The Clinical Characteristics And Eye Surface Cytology Transformation Of Allergic Conjunctivitis

Objective To understand the clinical characteristics and the transformation law of eye surface cytology of allergic conjunctivitis. Methods The symptoms, the signs, and the conjunctiva cytology of 60 cases of allergic conjunctivitis as well as 30 normal subjects (from June, 2004 to March, 2005) were evaluated and analyzed in our hospital. Results The average age of all 60 cases of allergic conjunctivitis was (37.66±11.56) years. The 38.33% of cases were male and 61.67% were female. The average scores were (13.24±4.38), Among the cases,68.33% were acute allergic conjunctivitis and 31.67%were chronic. There was significant difference between acute and chronic allergic conjunctivitis (P<0.05). The highest frequency of symptoms was itching and the one of signs was conjunctival congestion. The 28.30% of cases had history of asthma,allergic rhinitis or sensitization dermatitis. 86.67% of the cases can found eosinophils in their conjunctiva, while the control subjects can not found any eosinophils. Compare to the control subjects, the neutrophils, lymphocytes, and eosinophils of the patients'conjunctiva have obvious increase. The amount of inflammation cell and the frequency of conjunctiva squamous metaplasia have significant difference between allergic conjunctivitis and normal subjects. Conclusion Allergic conjunctivitis is a kind of normal eye surface disease, it mainly occurs in young and middle females (less than 40). The most important clinical characteristics of allergic conjunctivitis are itching and conjunctival conjestion. The acute allergic conjunctivitis and the chronic have similar course of diseases, but the symptoms and the signs of the acute are comparatively low. The sicken rate of acute allergic conjunctivitis are higher than the chronic, the state of an illness of the chronic is much serious than the acute. Different inflammation cells take part in the course of disease, the cytology inspect can provide reference criteria and diagnoses marker for allergic conjunctivitis. Allergic conjunctivitis is a kind of immune disease. There are different opinions about the classification of allergic conjunctivitis. According to the difference of the clinical characteristic, the course of diseases, and the prognosis, Hannouche divides the allergic conjunctivitis into 5: (1) Seasonal allergic conjunctivitis (SAC); (2) Perennial allergic conjunctivitis (PAC); (3) Giant papillaryconjunctivitis (GPC); (4) Vernal keratoconjunctivitis (VKC); (5) Atopic keratoconjunctivitis (AKC). Generally, (1), (2), and (3) have good prognosis results; while (4) and (5) easy do harm to eyesight. These 5 different kinds of allergic conjunctivitis have certain connects in clinic. In 1999, Calonge proposed that allergic conjunctivitis is caused by a type I IgE-dependent mechanism including acute allergic conjunctivitis and chronic allergic conjunctivitis. A cellular type IV reaction has been demonstrated in GPC, VKC and AKC in addition to many other factors. However, many patients cannot find the obvious contactant (especially the chronic allergic conjunctiviti), this brings quite difficulty to the clinical diagnosis and easy cause common mistakes to the clinical diagnosis. In order to diagnose the allergic conjunctivitis quickly and accurately, the clinical characteristics and eye surface cytology transformation of 60 cases of allergic conjunctivitis as well as 30 normal subjects are summarized and analyzed. The average age of the 60 cases of allergic conjunctivitis was (37.66±11.56) years. According to them, 26 cases are younger than 30 years old and 40 cases are less than 40 years old. The patients offemale are obviously more than males, and 28.30% of cases had history of asthma,allergic rhinitis or sensitization dermatitis. Among the cases,68.33% were acute allergic conjunctivitis and 31.67%were chronic. To understand the age, sex, and the contactant will be important to diagnose the allergic conjunctivitis accurately. The data of 60 cases proposed that the acute allergic conjunctivitis and the chronic have similar course of diseases, both the acute and the chronic have itching (about 96.66%) and conjunctival conjestion (100.00%). Especially itching, the average scores are 2.27±0.81. The frequency of corneal FL and proliferation of limbus is lower. All of these have important value to diagnose allergic conjunctivitis. So, if a patient does not have the symptoms of itching or serious cornea impairment, we can diagnose that he does not have allergic conjunctivitis. However, if a patient has the obvious symptoms of itching, we should make further diagnoses. The cure recipe to acute allergic conjunctivitis and chronic allergic conjunctivitis are quite different. According to the clinical data, the allergic conjunctivitis has some characteristics: (1) the sicken rate of acute allergic conjunctivitis are higher than the chronic. To all 60...