Exacerbation of signs and symptoms of allergic conjunctivitis by a controlled adverse environment challenge in subjects with a history of dry eye and ocular allergy

Paulo J Gomes,1 George W Ousler,1 Donna L Welch,1 Lisa M Smith,1 Jeffrey Coderre,1 Mark B Abelson1,21Ora Inc, Andover, MA; 2Harvard Medical School, Schepens Eye Research Institute, Boston, MA, USABackground: The goal of this study was to assess the effect of a controlled adverse environment (CAE) ch...

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Autores principales: Gomes PJ, Ousler GW, Welch DL, Smith LM, Coderre J, Abelson MB
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Publicado: Dove Medical Press 2013
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spelling oai:doaj.org-article:8cacfae70383463caa489769dd972ef22021-12-02T01:47:06ZExacerbation of signs and symptoms of allergic conjunctivitis by a controlled adverse environment challenge in subjects with a history of dry eye and ocular allergy1177-54671177-5483https://doaj.org/article/8cacfae70383463caa489769dd972ef22013-01-01T00:00:00Zhttp://www.dovepress.com/exacerbation-of-signs-and-symptoms-of-allergic-conjunctivitis-by-a-con-a12019https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Paulo J Gomes,1 George W Ousler,1 Donna L Welch,1 Lisa M Smith,1 Jeffrey Coderre,1 Mark B Abelson1,21Ora Inc, Andover, MA; 2Harvard Medical School, Schepens Eye Research Institute, Boston, MA, USABackground: The goal of this study was to assess the effect of a controlled adverse environment (CAE) challenge on subjects with both allergic conjunctivitis and dry eye.Methods: Thirty-three subjects were screened and 17 completed this institutional review board-approved study. Subjects underwent baseline ocular assessments and conjunctival allergen challenge (CAC) on days 0 and 3. Those who met the ocular redness and itching criteria were randomized to receive either the controlled adverse environment (CAE) challenge (group A, n = 9) or no challenge (group B, n = 8) at day 6. Thirty minutes after CAE/no-CAE, subjects were challenged with allergen and their signs and symptoms graded. Exploratory confocal microscopy was carried out in a subset of subjects at hourly intervals for 5 hours post-CAC on days 3 and 6.Results: Seven minutes post-CAC, subjects exposed to the CAE had significantly greater itching (difference between groups, 0.55 ± 0.25, P = 0.028), conjunctival redness (0.59 ± 0.19, P = 0.002), episcleral redness (0.56 ± 0.19, P = 0.003) and mean overall redness (mean of conjunctival, episcleral, and ciliary redness, 0.59 ± 0.14, P < 0.001). The mean score at 7, 15, and 20 minutes post-CAC for conjunctival redness (0.43 ± 0.17, P = 0.012), episcleral redness (0.49 ± 0.15, P = 0.001), mean overall redness in all regions (0.43 ± 0.15, P = 0.005), and mean chemosis (0.20 ± 0.08, P = 0.017) were also all significantly greater in CAE-treated subjects. Confocal microscopic images of conjunctival vessels after CAC showed more inflammation in CAE-treated subjects.Conclusion: In subjects with both dry eye and allergic conjunctivitis, exposure to adverse environmental conditions causes an ocular surface perturbation that can intensify allergic reactions.Keywords: allergic conjunctivitis, dry eye, conjunctival allergen challenge, controlled adverse environment, comorbidityGomes PJOusler GWWelch DLSmith LMCoderre JAbelson MBDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2013, Iss default, Pp 157-165 (2013)
institution DOAJ
collection DOAJ
language EN
topic Ophthalmology
RE1-994
spellingShingle Ophthalmology
RE1-994
Gomes PJ
Ousler GW
Welch DL
Smith LM
Coderre J
Abelson MB
Exacerbation of signs and symptoms of allergic conjunctivitis by a controlled adverse environment challenge in subjects with a history of dry eye and ocular allergy
description Paulo J Gomes,1 George W Ousler,1 Donna L Welch,1 Lisa M Smith,1 Jeffrey Coderre,1 Mark B Abelson1,21Ora Inc, Andover, MA; 2Harvard Medical School, Schepens Eye Research Institute, Boston, MA, USABackground: The goal of this study was to assess the effect of a controlled adverse environment (CAE) challenge on subjects with both allergic conjunctivitis and dry eye.Methods: Thirty-three subjects were screened and 17 completed this institutional review board-approved study. Subjects underwent baseline ocular assessments and conjunctival allergen challenge (CAC) on days 0 and 3. Those who met the ocular redness and itching criteria were randomized to receive either the controlled adverse environment (CAE) challenge (group A, n = 9) or no challenge (group B, n = 8) at day 6. Thirty minutes after CAE/no-CAE, subjects were challenged with allergen and their signs and symptoms graded. Exploratory confocal microscopy was carried out in a subset of subjects at hourly intervals for 5 hours post-CAC on days 3 and 6.Results: Seven minutes post-CAC, subjects exposed to the CAE had significantly greater itching (difference between groups, 0.55 ± 0.25, P = 0.028), conjunctival redness (0.59 ± 0.19, P = 0.002), episcleral redness (0.56 ± 0.19, P = 0.003) and mean overall redness (mean of conjunctival, episcleral, and ciliary redness, 0.59 ± 0.14, P < 0.001). The mean score at 7, 15, and 20 minutes post-CAC for conjunctival redness (0.43 ± 0.17, P = 0.012), episcleral redness (0.49 ± 0.15, P = 0.001), mean overall redness in all regions (0.43 ± 0.15, P = 0.005), and mean chemosis (0.20 ± 0.08, P = 0.017) were also all significantly greater in CAE-treated subjects. Confocal microscopic images of conjunctival vessels after CAC showed more inflammation in CAE-treated subjects.Conclusion: In subjects with both dry eye and allergic conjunctivitis, exposure to adverse environmental conditions causes an ocular surface perturbation that can intensify allergic reactions.Keywords: allergic conjunctivitis, dry eye, conjunctival allergen challenge, controlled adverse environment, comorbidity
format article
author Gomes PJ
Ousler GW
Welch DL
Smith LM
Coderre J
Abelson MB
author_facet Gomes PJ
Ousler GW
Welch DL
Smith LM
Coderre J
Abelson MB
author_sort Gomes PJ
title Exacerbation of signs and symptoms of allergic conjunctivitis by a controlled adverse environment challenge in subjects with a history of dry eye and ocular allergy
title_short Exacerbation of signs and symptoms of allergic conjunctivitis by a controlled adverse environment challenge in subjects with a history of dry eye and ocular allergy
title_full Exacerbation of signs and symptoms of allergic conjunctivitis by a controlled adverse environment challenge in subjects with a history of dry eye and ocular allergy
title_fullStr Exacerbation of signs and symptoms of allergic conjunctivitis by a controlled adverse environment challenge in subjects with a history of dry eye and ocular allergy
title_full_unstemmed Exacerbation of signs and symptoms of allergic conjunctivitis by a controlled adverse environment challenge in subjects with a history of dry eye and ocular allergy
title_sort exacerbation of signs and symptoms of allergic conjunctivitis by a controlled adverse environment challenge in subjects with a history of dry eye and ocular allergy
publisher Dove Medical Press
publishDate 2013
url https://doaj.org/article/8cacfae70383463caa489769dd972ef2
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