LIMBAL VERNAL KERATOCONJUNCTIVITIS IN THE TROPICS

Objective: This study aimed to describe the pathology of vernal kerato conjunctivitis (VKC) in children from Kenya, Design: Case series, Part icipants: Ten patients with clinically active and untreated limbal VKC and five age-matched control subjects without external eye disease we re recruited from a district eye hospital in Kenya. Main Outcome Measu res: Paraffin sections of limbal and tarsal conjunctiva were examined by tinctorial and immunocytochemical methods to characterize the infla mmatory infiltrate. Results: In comparison with control subjects, pati ents with VKC were more likely to show squamous metaplasia of the tars al conjunctiva, The patients with VKC had cellular infiltration of bot h the stroma and epithelium consistent with chronic inflammation, part icularly in the biopsy specimens taken from the limbus, In tarsal conj unctiva, the stromal infiltrate consisted of a diffuse T-lymphocyte re action with clustering of B-lymphocytes; mast cells, immunoglobulin E (IgE) plasma cells, and eosinophils also were prominent. Mast cells an d eosinophils were found within the epithelium in the more severely in flamed biopsy specimens. Conclusions: These features are similar to th ose in reports of VKC in temperate regions, although the degree of B-l ymphocyte clustering is greater in tropical patients with VKC, Althoug h none of the patients had other symptoms of atopy, the authors findin gs are consistent with those for an allergic basis for this disease.