春季カタル
WordNet
- of or characteristic of or occurring in spring; "the vernal equinox"
- inflammation of the cornea and conjunctiva
PrepTutorEJDIC
- 春の,春に起こる / 青春の,生き生きとした
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/11/30 23:36:30」(JST)
[Wiki en表示]
Vernal keratoconjunctivitis (VKC) or Spring catarrh is a recurrent, bilateral, and self-limiting inflammation of conjunctiva, having a periodic seasonal incidence.
Contents
- 1 Etiology
- 2 Predisposing factors
- 3 Pathology
- 4 Clinical picture
- 5 Vernal keratopathy
- 6 Treatment
- 7 See also
- 8 References
Etiology[edit]
VKC is thought to be an allergic disorder in which IgE mediated mechanism play a role. Such patients often give family history of other atopic diseases such as hay fever, asthma or eczema, and their peripheral blood shows eosinophilia and increased serum IgE levels.
Predisposing factors[edit]
- Age and sex – 4–20 years; more common in boys than girls.
- Season – More common in summer. Hence, the name Spring catarrh is a misnomer. Recently it is being labelled as Warm weather conjunctivitis.
- Climate – More prevalent in the tropics.
Pathology[edit]
- Conjunctival epithelium undergoes hyperplasia and sends downward projection into sub-epithelial tissue.
- Adenoid layer shows marked cellular infiltration by eosinophils, lymphocytes, plasma cells and histiocytes.
- Fibrous layer show proliferation which later undergoes hyaline changes.
- Conjunctival vessels also show proliferation, increased permeability and vasodilation.
Clinical picture[edit]
- Symptoms- VKC is characterised by marked burning and itchy sensations which may be intolerable and accentuates when patient comes in a warm humid atmosphere. Associated symptoms include mild photophobia, lacrimation, stringy discharge and heaviness of eyelids.
- Signs of VKC can be described in three clinical forms.
- Palpebral form- Usually upper tarsal conjunctiva of both the eyes is involved. Typical lesion is characterized by the presence of hard, flat-topped papillae arranged in cobblestone or pavement stone fashion. In severe cases papillae undergo hypertrophy to produce cauliflower-like excrescences of 'giant papillae'.
- Bulbar form- It is characterised by dusky red triangular congestion of bulbar conjunctiva in palpebral area, gelatinous thickened accumulation of tissue around limbus and presence of discrete whitish raised dots along the limbus (Tranta's spots).
- Mixed form- Shows the features of both palpebral and bulbar types.
Vernal keratopathy[edit]
Corneal involvement in VKC may be primary or secondary due to extension of limbal lesions. Vernal keratopathy includes 5 types of lesions.
- Punctuate epithelial keratitis.
- Ulcerative vernal keratitis.
- Vernal corneal plaques.
- Subepithelial scarring.
- Pseudogerontoxon.
Treatment[edit]
- Local therapy- Topical steroids are effective. Commonly used solutions are of fluorometholone, medrysone, betamethasone or dexamethasone. Mast cell stabilizers such as sodium cromoglycate (2%) drops 4–5 times a day are quite effective in controlling VKC, especially atopic ones. Azelastine eyedrops are also effective. Topical antihistamines can be used. Acetyl cysteine (.0.5%) used topically has mucolytic properties and is useful in the treatment of early plaque formation. Topical Cyclosporine is reserved for unresponsive cases.
- Systemic therapy- Oral antihistamines and oral steroids for severe cases.
- Treatment of large papillae- Cryo application, surgical excision or supratarsal application of long-acting steroids.
- General measures include use of dark goggles to prevent photophobia, cold compresses and ice pack for soothing effects, change of place from hot to cold areas.
- Desensitization has also been tried without much rewarding results.
- Treatment of vernal keratopathy- Punctuate epithelial keratitis require no extra treatment except that instillation of steroids should be increased. Large vernal plaque requires surgical excision. Ulcerative vernal keratitis require surgical treatment in the form of debridement, superficial keratectomy, excimer laser therapeutic keratectomy, as well as amniotic membrane transplantation to enhance re-epithelialisation.
See also[edit]
- Conjunctivitis
- Allergic conjunctivitis
References[edit]
- A K Khurana's Comprehensive ophthalmology
UpToDate Contents
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- 1. 春季カタル vernal keratoconjunctivitis
- 2. アトピー性角結膜炎 atopic keratoconjunctivitis
- 3. アレルギー性結膜炎：臨床症状および診断 allergic conjunctivitis clinical manifestations and diagnosis
- 4. 中毒性結膜炎 toxic conjunctivitis
- 5. 巨大乳頭結膜炎 giant papillary conjunctivitis
English Journal
- Corneal complications of vernal keratoconjunctivitis.
- Solomon A1.
- Current opinion in allergy and clinical immunology.Curr Opin Allergy Clin Immunol.2015 Oct;15(5):489-94. doi: 10.1097/ACI.0000000000000202.
- PURPOSE OF REVIEW: Vernal keratoconjunctivitis (VKC) is a severe bilateral chronic allergic inflammatory disease of the ocular surface. In most of the cases, the disease is limited to the tarsal conjunctiva and to the limbus. However, in the more severe cases, the cornea may be involved, leading to
- PMID 26258926
- Environmental aeroallergens and allergic rhino-conjunctivitis.
- Jalbert I1, Golebiowski B.
- Current opinion in allergy and clinical immunology.Curr Opin Allergy Clin Immunol.2015 Oct;15(5):476-81. doi: 10.1097/ACI.0000000000000205.
- PURPOSE OF REVIEW: The rising prevalence of allergy and of allergic rhino-conjunctivitis is associated with changes in modern lifestyle. The current period of rapid development and consequent urbanization and migration, coupled with changes in climate, is facilitating a growth in rates of allergy.RE
- PMID 26258925
- Epidemiology of allergic conjunctivitis: clinical appearance and treatment patterns in a population-based study.
- Leonardi A1, Castegnaro A, Valerio AL, Lazzarini D.
- Current opinion in allergy and clinical immunology.Curr Opin Allergy Clin Immunol.2015 Oct;15(5):482-8. doi: 10.1097/ACI.0000000000000204.
- PURPOSE OF REVIEW: To analyse the most recently published studies on the prevalence of allergic conjunctivitis alone or in association with allergic rhinitis, and the clinical and demographic aspects of the disease.RECENT FINDINGS: Allergic conjunctivitis or conjunctival symptoms are present in 30-7
- PMID 26258920
Japanese Journal
- アレルギー用語解説シリーズ 免疫抑制点眼薬(カルシニューリン阻害薬)
- アレルギー性結膜疾患における涙液中IgE抗体の病因・診断・治療的意義 (特集 アレルギー疾患におけるIgEの病因病態的意義の新たな検討)
- アレルギー性結膜疾患診療ガイドライン(第二版) : 点眼治療のポイント(ガイドラインのワンポイント解説)
Related Links
- Why is allergic eye disease a problem for eye workers? Why is allergic eye disease, and vernal keratoconjunctivitis (VKC) in particular, a problem for eye ... A large number of children are affected Over a quarter of 2,250 children seen ...
- Vernal keratoconjunctivitis (VKC) is a recurrent ocular inflammatory disease that has a seasonal incidence. It is basically an allergic eye condition, accounting for roughly 0.1 to 0.5% of ocular disease. It tends to occur more in dry ...
★リンクテーブル★
[★]
- 英
- vernal conjunctivitis, vernal keratoconjunctivitis VKC, spring catarrh
- ラ
- conjunctivitis vernalis
- 関
- アレルギー性結膜炎、巨大乳頭結膜炎、アトピー性結膜炎、結膜炎
参考
- 1. [charged] 春季カタル - uptodate [1]
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