Allergic and Immunologic Diseases of the Eye

Barney, Neal P.; Graziano, Frank M.; Cook, Ellen B.; Stahl, James L.

doi:10.1016/b978-0-323-05659-5.00064-4

Cited by 15 publications

(50 citation statements)

References 154 publications

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“…1-15, 26, 33, 35, 55 Generally, the SAC and PAC represent more functional and almost fully reversible process, whereas the VKC and AKC (and to a certain extent also GPC) may be characterized as a functional-morphologic process associated with usually reversible damage of the corneal surface (epithelium), and sometimes also with temporary damage of limbus and/or papillae, and incidentally also with other complications, such as formation of corneal scars, lacrimal way contractures and uveitis. 1,6,8,9,18,26,[33][34][35] The objective conjunctiva-related signs typical for allergic conjunctivitis (SAC, PAC) include hyperaemia (injection) of the conjunctiva, chemosis, tearing (hyperlacrimation, watery discharge) and sometimes palpebral oedema. The subjective conjunctiva-related symptoms consist of itching, burning and sometimes blurred vision and photophobia.…”

Section: Discussionmentioning

confidence: 99%

Cytologic Changes in Tears During the Late Type of Secondary Conjunctival Response Induced by Nasal Allergy

Pelikán¹

2011

Conjunctivitis - A Complex and Multifaceted Disorder

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Section: Discussionmentioning

confidence: 99%

Cytologic Changes in Tears During the Late Type of Secondary Conjunctival Response Induced by Nasal Allergy

Pelikán¹

2011

Conjunctivitis - A Complex and Multifaceted Disorder

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“…There are several drugs with antihistamine and mast cell stabilizing activities that generally provide relief of the itching associated with SAC (Bielory 2008). As a result of these attributes, the dual action products are currently the most commonly prescribed group of agents for ocular allergy (Barney & Graziano 2003). These multiple-action agents are generally well tolerated and can be used for longer-term treatment of SAC; side-effects are generally mild and include headache, cold-like symptoms, burning, stinging and possible transient bitter taste (Bielory 2008;Wallace et al 2008).…”

Section: Topical Antihistamine ⁄ Mast Cell Stabilizer Agentsmentioning

confidence: 99%

“…This action results in the reduction of hyperaemia, chemosis and ocular redness through the constriction of blood vessels supplying the eye (Barney & Graziano 2003). There is also some amelioration of ocular itching associated with the use of topical decongestants (American Academy of Allergy, Systemic antihistamines may be used to control the symptoms of rhinoconjunctivitis, but these agents may have only partial efficacy for ocular symptoms (Bhargava et al 1998;Butrus & Portela 2005;Bielory & Friedlaender 2008).…”

Section: Topical Decongestantsmentioning

confidence: 99%

“…As a result, mast cell stabilizers provide relief from SAC by preventing both the early and late phases of the allergic response (Butrus & Portela 2005). Mast cell stabilizers reduce hyperaemia, itching and irritation, although efficacy in SAC varies among different agents (Bhargava et al 1998;Barney & Graziano 2003). Mast cell stabilizers are most effective when administered prior to the triggering of the allergic reaction and should therefore be used prophylactically (Bhargava et al 1998;Butrus & Portela 2005), although patients may notice some improvements in SAC signs and symptoms within 24-48 hr if they are used following exposure to the allergen (Bielory & Friedlaender 2008).…”

Section: Mast Cell Stabilizersmentioning

confidence: 99%

“…As antihistamines and decongestants have different but complementary mechanisms of action, these agents are often combined into a single product that can have better efficacy than either agent alone (Barney & Graziano 2003;Wallace et al 2008). However, these agents generally have a shorter duration of action in addition to the side-effects associated with decongestants and antihistamines, such as rebound hyperaemia with continued use (The Medical Letter 2007).…”

Section: Topical Antihistamine ⁄ Decongestant Agentsmentioning

confidence: 99%

See 2 more Smart Citations

Management of seasonal allergic conjunctivitis: guide to therapy

Bielory

O’Brien

Bielory

2011

Acta Ophthalmologica

105

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Abstract.Seasonal allergic conjunctivitis (SAC) is an inflammatory response of the conjunctiva triggered by exposure to seasonal allergens. Treatment options for SAC include artificial tears, antihistamines, decongestants, mast cell stabilizers, nonsteroidal anti‐inflammatory drugs, dual antihistamine/mast cell stabilizers, immunotherapy and corticosteroids. Topical, intranasal and systemic formulations of corticosteroids have traditionally provided the most effective relief of the inflammation and signs and symptoms associated with severe, acute exacerbations of SAC. However, steroid‐induced ocular and systemic side‐effects have limited the prescribing of these agents. This limitation of traditional corticosteroids led to the development of modified corticosteroids that retain the anti‐inflammatory mechanism of action of traditional corticosteroids with a much‐improved safety profile because of their rapid breakdown to inactive metabolites after exerting their activity. The development of one such novel corticosteroid, loteprednol etabonate (LE), led to the insertion of an ester (instead of a ketone) group at the carbon‐20 (C‐20) position of the basic corticosteroid structure. Clinical trials assessing this C‐20 ester corticosteroid have demonstrated similar efficacy to C‐20 ketone corticosteroids in the prevention or treatment of the signs and symptoms of SAC but with a greatly improved safety profile, as the C‐20 ester corticosteroid is less likely to elevate intraocular pressure. In addition, the ketone at the C‐20 position has been implicated in the formation of cataract, while nonketolic corticosteroids do not form Schiff base intermediates with lens proteins, which is a common first step in cataractogenesis. The clinical relevance of the C‐20 ester corticosteroid class, as modelled by LE, is that they provide both effective and safe treatment of the inflammation associated with SAC and relief of its signs and symptoms. Loteprednol etabonate offers a well‐tolerated treatment option for patients with debilitating acute exacerbations as well as chronic forms of the disease.

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Allergic Conjunctivitis and Nasal Allergy

Pelikán¹

2010

Curr Allergy Asthma Rep

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Allergic conjunctivitis (AC) can be divided into the primary form (caused by an allergic reaction occurring primarily in the conjunctivae) and the secondary form (induced by allergic reaction originating primarily in the nasal mucosa, where the released mediators can reach conjunctiva through the lacrimal system, the blood, the lymphatic network, or the neurogenic network). Patients with primary AC develop an immediate, late, or delayed conjunctival response (CR) during conjunctival provocation tests. Patients with secondary AC develop an immediate, late, or delayed type of secondary CR, induced by the nasal allergic reaction, due to the nasal allergen challenge. Various hypersensitivity mechanisms may be involved in the particular CR types. The secondarily induced AC and CRs can only be confirmed by nasal provocations tests, performed by rhinomanometry combined with recording of conjunctival signs. The existence of the primary and secondarily induced AC has an impact on treatment of this disorder.

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Allergic and Immunologic Diseases of the Eye

Cited by 15 publications

References 154 publications

Cytologic Changes in Tears During the Late Type of Secondary Conjunctival Response Induced by Nasal Allergy

Cytologic Changes in Tears During the Late Type of Secondary Conjunctival Response Induced by Nasal Allergy

Management of seasonal allergic conjunctivitis: guide to therapy

Allergic Conjunctivitis and Nasal Allergy

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