Correlation between conjunctival provocation test (CPT) and systemic allergometric tests in allergic conjunctivitis

Leonardi, Andrea; Fregona, I.; Gismondi, Maurizio; Daniotti, E; Carniel, G; Secchi, Antonio

doi:10.1038/eye.1990.109

Cited by 43 publications

(22 citation statements)

References 11 publications

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“…However, in our experience, we have found an approximately 60% to 70% correlation between positive skin tests and positive reaction to allergen instilled in the eye; therefore, if skin testing is solely relied on, some patients will be enrolled who might not have allergy to the pollen in season. Others have also seen a similar correlation [21]. Often, entry criteria require a patient to present in the office with a positive skin test and positive clinical signs and symptoms of ocular allergy.…”

Section: Factors Affecting Data In the Environmental Modelmentioning

confidence: 92%

Conjunctival allergen challenge: Models in the investigation of ocular allergy

Abelson

Loeffler

2003

Curr Allergy Asthma Rep

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Recently, the number of agents to treat ocular allergy has increased dramatically, from three (pheniramine, antazoline, cromolyn) to more than a dozen. A general increase in the incidence of atopy in recent years and the fact that patients are becoming less tolerant of bothersome signs and symptoms have been driving forces in this increase. As visual tasking, such as reading and working on a computer, has become more prevalent, there is an increased awareness of ocular allergy and the impact it has on quality of life and productivity at work and school. With the need for more effective medications, the development of models, such as the conjunctival allergen challenge (CAC), has made the identification of new agents more efficient. In this article, we review the relevant background on the science behind allergen challenges in the eye, how models are designed, and how models are used in the field today.

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Section: Factors Affecting Data In the Environmental Modelmentioning

confidence: 92%

Conjunctival allergen challenge: Models in the investigation of ocular allergy

Abelson

Loeffler

2003

Curr Allergy Asthma Rep

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“…These studies suggested that CAC was helpful both in determining the etiology and diagnosis and therapy monitoring [29]. Some reports have also shown that patients allergic to common aeroallergens with negative SPT and suspected ocular allergic symptoms had a positive reaction to specific eye challenge [33,34,35]. CAC with latex was first described by Kurtz et al [36].…”

Section: Discussionmentioning

confidence: 99%

Clinical Value of Conjunctival Allergen Challenge in Diagnosing Allergic Conjunctivitis Related to Latex

Chełmińska

Niedoszytko

Jassem³

2010

Int Arch Allergy Immunol

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Background: The clinical value of conjunctival allergen challenge (CAC) with latex allergen in patients with allergic conjunctivitis remains undefined. The aim of this study was to assess the value of conjunctival allergen challenge with latex extract in a group of patients with latex sensitization and a history of conjunctivitis after contact with latex products. Methods: Fifty patients who had symptoms of conjunctivitis following contact with latex were studied. The control group consisted of 30 subjects without any symptoms of conjunctivitis, negative skin prick test and sIgE <0.35 kU/l for latex. Questionnaires on signs and symptoms, skin prick tests with latex, sIgE and CAC with latex extract were administered. The study was performed at the Department of Allergology of the Medical University of Gdansk in Poland. Results: CAC with latex was positive in 46 patients (92%) and in none of the control group. CAC was the most sensitive diagnostic method (92% sensitivity and 100% specificity). The sensitivity of other methods (skin prick test and sIgE) was lower: 84 and 88%, respectively. Provocation did not induce any serious adverse events. Conclusion: Our study demonstrated the high sensitivity and safety of CAC with the extract of latex allergens in the diagnosis of patients with latex allergy. This method may be considered a diagnostic option in cases with uncertain diagnosis.

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“…Furthermore, direct mucosal allergen challenges, such as the conjunctival or nasal provocation test, are used as secondary diagnostic tools for a variety of purposes, for example: to confirm the diagnosis of occupational allergy; to confirm the diagnosis of seasonal allergic rhinitis and to exclude a clinical silent sensitization, if the result of a skin prick test or specific IgE measurement is contrary to the patient's clinical symptoms; assessing the symptoms directly at the organ level to evaluate the indication or efficacy of any antiallergic treatment, and to research the immunopathologic mechanisms in the target organs [7,10,11]. Nevertheless, different opinions exist in the literature as to whether the conjunctival provocation test (CPT) serves generally as a model of allergic rhinoconjunctivitis [7,12,13,14] or not [14,15]. The CPT has not yet been consistently defined by any international guidelines and is mentioned less often in the current literature [6,10].…”

Section: Introductionmentioning

confidence: 99%

Objectifying the Conjunctival Provocation Test: Photography-Based Rating and Digital Analysis

Dogan

Astvatsatourov

Deserno

et al. 2013

Int Arch Allergy Immunol

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Background: Patients with allergic rhinoconjunctivitis are susceptible to both nasal and ocular symptoms. The conjunctival provocation test (CPT) is an established diagnostic procedure used in allergic rhinoconjunctivitis, particularly to document a patient's current reactivity to allergens. To date, there are no international guidelines defining the CPT. No approved evaluation method exists for interpreting CPT results. This paper aims to establish the digital analysis of macroimages as an objective, validated and standardized method for interpreting CPT results. Methods: In a clinical immunotherapy trial with 155 patients, treatment progress was documented based on the CPT. Local investigators used a symptom score to grade tearing, reddening and the patients' subjective perception of symptoms (mucosal irritation). A central observer rated conjunctival hyperemia via digital photography. Digital image analysis software was utilized to determine conjunctival hyperemia. Results: Spearman's correlation between the local investigators' and the central observer's ratings was r = 0.729 (p < 0.001); the percentage of total agreement was 48% (based on 739 photos). Digital image analysis (based on 48 photos) had a high percentage of total agreement with the central observer's ratings (69%) but a low percentage of total agreement with the investigators' ratings (38%). The corresponding correlations were r = 0.264 and 0.064, respectively. Conclusion: Photography-based rating by a central observer may represent a valuable supplement to the local investigator's assessment for making an objective evaluation of CPT results. Digital image analysis possesses the potential of being an objective evaluation method compared to the wide-spread subjective evaluation by the investigators.

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Correlation between conjunctival provocation test (CPT) and systemic allergometric tests in allergic conjunctivitis

Cited by 43 publications

References 11 publications

Conjunctival allergen challenge: Models in the investigation of ocular allergy

Conjunctival allergen challenge: Models in the investigation of ocular allergy

Clinical Value of Conjunctival Allergen Challenge in Diagnosing Allergic Conjunctivitis Related to Latex

Objectifying the Conjunctival Provocation Test: Photography-Based Rating and Digital Analysis

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