The Clinical Correlation Between Allergic Conjunctivitis And Dry Eye In Children

PurposeTo evaluate the clinical symptoms,prevalence of dry eye,tear film function and ocular inflammation in children with seasonal allergic conjunctivitis(SAC)or perennial allergic conjunctivitis(PAC).And to analyze the correlations beween tear film function and ocular inflammationMethodsA case-control study was conducted between 1 May 2017 and 30 December 2017 in Fujian Provincial Hospital.There were 42 children,6-12 years of age,with SAC or PAC and 30 age-and gender-matched healthy children as a control.Before ophthalmic measurement,Each subjects was asked past allergic history,clinical symptoms,slit-lamp examinations.Then,we performed tear meniscus height(TMH),non-invasive tear break-up time(NIBUT),bulbar redness(BR),fluorescent corneal staining(FCS)with Keratograph 5M on both groups.Patients with SAC and PAC were administered to skin prick tests.Correlation analysis were performed to evaluate relationship between measures of tear film function and allergic conjunctivitis in youths with AC.Results1.In this study,the mean age was 7.86±1.53 years in AC group and 7.50±1.34 years in the control group.There were 22 males and 20 females in AC group(42 patients,84 eyes)and 16 males and 14 females in the control group(30 patients,60 eyes).The difference between groups for age and gender was no statistically significant(P>0.05,both comparisons).2.The clinical symptoms of AC:Among the proportion of clinical symptoms in AC group,increasing blink was the highest,reaching 85.71%,foreign body sensation was the lowest,at 4.76%.The proportion of other clinical symptoms were as follow,78.57%in burbal redness,64.28%in rubbing eyes frequently,23.81%in dry eye,21.42%in itching,19.04%in increasing secretions of eyes,14.28%in photophobia,and 14.28%in tearing.3.The AC group compared with the control group:The prevalence of dry eye was 81.0%(68/84 eyes)in the AC group and 21.67%(13/60 eyes)in the control group(X2=49.98,P<0.001).The level of NIBUT-av(classified by NIBUT-av?14 seconds,?7 and<14 seconds,<7 seconds)was 19.05%(16/84 eyes),25.00%(21/84 eyes),55.95%(47/84 eyes)in the AC group,and 47 eyes(78.33%),13 eyes(21.67%),no eyes(0%)in the control group respectively.;The results of TMH was 0.16±0.05 m,was lower than 0.24±0.03 mm in the control group(t=11.865,P<0.001);The results of NIBUT-f was 6.71±4.98 seconds,was lower than 11.80±3.53 seconds in the control group,the difference was statistically significant(t=-5.795,P<0.001);The results of NIBUT-av was 8.71±5.69 seconds,was lower than 16.35±2.92 seconds in the control group(t=-9.888,P<0.001);The resuls of bulbar redness was 1.6±0.4,was higher than 0.8±0.2 in the control group(t=13.852,P<0.001).4.Correlation analysis between tear film function and ocular inflammation:The values of NIBUT-av in AC group showed a srtong negative correlation with bulbar redness(r =-0.763,P<0.001).Statistically,mild correlations were found between NIBUT-av and TMH,skin test grade in AC group(r=0.315,-0.298,and P = 0.004,0.0013,respectively).And there were no relationship between TMH and BR,skin test grade(P>0.05).ConclusionThis study showed that the prevalence of dry eye tended to be higher in young children with SAC and PAC.Compared with healthy children,children with AC had lower TMH,shorter NIBUTs and higher bulbar redness.Tear film dysfunction was closely relate to clinical inflammation of ocular surface in AC.Therefore,more attention should be paid to the evaluation and treatment of dry eye and ocular inflammation in pediatric population with SAC and PAC.