ANTIGEN SENSITIVITY EVALUATED BY TEAR-SPECIFIC AND SERUM-SPECIFIC IGE, SKIN-TESTS, AND CONJUNCTIVAL AND NASAL PROVOCATION TESTS IN PATIENTSWITH OCULAR ALLERGIC DISEASE
A. Leonardi et al., ANTIGEN SENSITIVITY EVALUATED BY TEAR-SPECIFIC AND SERUM-SPECIFIC IGE, SKIN-TESTS, AND CONJUNCTIVAL AND NASAL PROVOCATION TESTS IN PATIENTSWITH OCULAR ALLERGIC DISEASE, Eye, 7, 1993, pp. 461-464
The potential for ocular allergic patients to have a site-specific ant
igen sensitisation was investigated using various diagnostic tests of
allergen sensitivity in subjects with allergic conjunctivitis (AC: n =
135), vernal keratoconjunctivitis (VK: n = 20), rhinoconjunctivitis (
n = 20) or rhinitis (N = 10). In the AC and VK patients, skin tests an
d conjunctival provocation tests (CPT) were performed, and the levels
of specific IgE in serum and in tears were identified. A subgroup of 3
6 patients was also challenged with a nasal-specific provocation test
(NPT). Results showed a poor correlation between skin test results and
tear-specific IgE, and also between serum-specific IgE and tear-speci
fic IgE in both AC and VK patients (K<0.3). CPT and tear IgE were sign
ificantly correlated (K = 0.5) in the ocular allergic population. In p
atients with rhinoconjunctivitis or rhinitis, and in 10 normal subject
s, results of CPT and NPT were in 100% agreement. Conversely, in patie
nts with only conjunctivitis, little correlation was found between the
results of CPT and NPT (K = 0.3). Tear-specific IgE was the only posi
tive diagnostic sign of antigen sensitivity in 35% of VK patients and
30% of AC patients. These results suggest that the conjunctiva can be
a uniquely sensitised target organ in allergic patients.