Vernal keratoconjunctivitis: Current immunological and clinical evidence and the potential role of omalizumab

Doan, Serge; Papadopoulos, Nikolaos G.; Lee, Jason K.; Leonardi, ﻿Salvatore; Manti, Sara; Lau, Susanne; Rondón, Carmen; Sharma, Vibha; Pleyer, Uwe; Jaumont, Xavier; Lazarewicz, Slawomir

doi:10.1016/j.waojou.2023.100788

Cited by 6 publications

(5 citation statements)

References 62 publications

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“…Four studies were found to lack data description. The best performance was attained by Dahlmann-Noor et al [109] and Doan et al [110] (11/12), followed by Mehta et al [36] and Ghauri et al [111] (10/12). Except for Singh et al [33], they all performed excellent literature research, detailing search terms and inclusion criteria.…”

Section: Quality Assessmentmentioning

confidence: 97%

Vernal Keratoconjunctivitis: A Systematic Review

Bruschi,

Ghiglioni,

Cozzi

et al. 2023

Clinic Rev Allerg Immunol

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Vernal keratoconjunctivitis (VKC) is a chronic, bilateral corneal and conjunctival problem which typically presents in young individuals. VKC is characterized by itching, photophobia, white mucous discharge, lacrimation, foreign body sensation, and pain due to corneal involvement of shield ulcers. Vernal keratoconjunctivitis is categorized within ocular diseases. The diagnosis is clinical, as no sure biomarkers pathognomonic of the disease have yet been identified. The VKC therapy relies on different types of drugs, from antihistamines and topical steroids to cyclosporine or tacrolimus eye drops. In extremely rare cases, there is also the need for surgical treatment for the debridement of ulcers, as well as for advanced glaucoma and cataracts, caused by excessive prolonged use of steroid eye drops. We performed a systematic review of the literature, according to PRISMA guideline recommendations. We searched the PubMed database from January 2016 to June 2023. Search terms were Vernal, Vernal keratoconjunctivitis, and VKC. We initially identified 211 articles. After the screening process, 168 studies were eligible according to our criteria and were included in the review. In this study, we performed a systematic literature review to provide a comprehensive overview of currently available diagnostic methods, management of VKC, and its treatments.

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Section: Quality Assessmentmentioning

confidence: 97%

Vernal Keratoconjunctivitis: A Systematic Review

Bruschi,

Ghiglioni,

Cozzi

et al. 2023

Clinic Rev Allerg Immunol

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“…The main goals of VKC treatment include controlling acute symptoms and preventing recurrent disease. Currently, there are no well-established treatment guidelines for VKC, and options are individualized based on disease stage, severity, and duration [ 108 ]. Because the immunopathogenesis of VKC is multifactorial, the use of a combination of agents with more direct effects on the inflammatory processes is ideal to control acute symptoms and prevent recurrent disease [ 4 ].…”

Section: Management Of Vkcmentioning

confidence: 99%

“…Because the immunopathogenesis of VKC is multifactorial, the use of a combination of agents with more direct effects on the inflammatory processes is ideal to control acute symptoms and prevent recurrent disease [ 4 ]. Non-pharmacological disease management includes the identification and avoidance of specific allergens, and pharmacological therapy includes antihistamines, mast cell stabilizers, and non-steroidal anti-inflammatory drugs (NSAIDs) [ 4 , 108 , 109 ]. Mild disease is typically managed with topical mast cell stabilizers, antihistamines, or dual-acting agents [ 5 , 110 , 111 ].…”

Section: Management Of Vkcmentioning

confidence: 99%

“…Such therapies are currently not approved for allergic eye disease; however, it has been reported that the off-label use of these agents provides promising results in the treatment of ocular allergic disease. Specifically, omalizumab, a humanized monoclonal anti-IgE antibody, appears to offer therapeutic relief in patients with severe VKC by targeting the IgE-mediated pathophysiology of the condition [ 108 , 151 ]. Larger controlled clinical trials are needed to establish the role of biologics and monoclonal antibodies, and to determine the appropriate dosage and administration of these agents in the treatment of VKC.…”

Section: Future Directionsmentioning

confidence: 99%

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Vernal Keratoconjunctivitis: Immunopathological Insights and Therapeutic Applications of Immunomodulators

Hehar,

Chigbu

2024

Life

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Vernal keratoconjunctivitis (VKC) is a complex and multifactorial disease process that employs Th2 cell-mediated immunologic processes, which involves the overexpression of interleukin 4 (IL-4), IL-5, IL-9, IL-13, and IL-31, and the activation of mast cells that release IL-5 and CCL-11, recruiting eosinophils to the site of inflammation. The disease primarily affects young males and is more common in regions with warm climates. VKC is characterized by persistent and recurrent conjunctival inflammation that can adversely affect the patient’s quality of life, and, when inadequately treated, may lead to a host of ocular complications, such as corneal shield ulcers and scarring. The major distinct forms of VKC include limbal or palpebral, which may occur in combination. The clinicopathological features of VKC include the presence of pseudogerontoxon, limbal gelatinous hyperplasia, and perilimbal hyperpigmentation. Topical immunomodulators are effective anti-steroidal options for controlling severe and chronic cases of VKC. This review will provide a brief overview of topical immunomodulators, including cyclosporin and tacrolimus, and will highlight the clinical manifestations, pathological mechanisms, and fibroproliferative changes in the conjunctiva that can result from recurrent disease.

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“…It is prevalent in regions with warm weather and high humidity. Untreated VKC can result in significant problems and potentially cause a decline in visual acuity or complete loss of vision [3] . The diagnosis of VKC relies on the evaluation of clinical presentations, symptoms, and indicators.…”

Section: Introductionmentioning

confidence: 99%

Vernal Keratoconjunctivitis in Sudan and Its Impact on Visual Acuity

Ibraheim,

Ahmed

2024

EJHS

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Purpose: Despite being a self-limiting allergy disorder, vernal keratoconjunctivitis (VKC) can potentially cause severe problems, including blindness, if not properly treated. Therefore, the objective of this study is to determine the effect of VKC on the visual acuity of patients. Materials and Methods: We conducted this prospective descriptive study between January 1, 2023, and April 20, 2024.So, all children with spring catarrh symptoms and signs were examined at Dr. Khalil's ophthalmology center (240 patients), including the cornea, bulbar, and palpebral conjunctiva, visual acuity was measured, visual impairment was classified by WHO, and structured questionnaires were completed. The study excludes children under the age of four years and those over the age of eighteen years. Findings: A total of 240 patients participated in this assessment, with an average age of 10 years. The male to female ratio for the age of disease beginning was 2.10:100. The mean age of onset was 5 years. The occurrence of this phenomenon is more prevalent in the younger age group compared to the older age group, with a ratio of 1.40 to 1.00. We have observed that a condition recurs in 85% of patients. The illness affects both eyes in 97% of the individuals. Regarding visual acuity, the majority of patients exhibit normal or reduced visual acuity, accounting for 81.6%, while the remaining 15% experience substantial visual impairment. 2.1% of patients were found to have severe visual impairment, while 1.3% were diagnosed Implications to Theory, Practice and Policy: VKC, is a prevalent disease in Sudan. It often affects both eyes and is more common in males than females. VKC tends to occur at a young age and often recurs in patients. Additionally, it can lead to severe consequences that result in a decline in visual acuity in over 18% of patients. Children with VKD should undergo continuous screening for their visual acuity.

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Vernal keratoconjunctivitis: Current immunological and clinical evidence and the potential role of omalizumab

Cited by 6 publications

References 62 publications

Vernal Keratoconjunctivitis: A Systematic Review

Vernal Keratoconjunctivitis: A Systematic Review

Vernal Keratoconjunctivitis: Immunopathological Insights and Therapeutic Applications of Immunomodulators

Vernal Keratoconjunctivitis in Sudan and Its Impact on Visual Acuity

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