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
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/8cacfae70383463caa489769dd972ef2
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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 &plusmn; 0.25, P = 0.028), conjunctival redness (0.59 &plusmn; 0.19, P = 0.002), episcleral redness (0.56 &plusmn; 0.19, P = 0.003) and mean overall redness (mean of conjunctival, episcleral, and ciliary redness, 0.59 &plusmn; 0.14, P &lt; 0.001). The mean score at 7, 15, and 20 minutes post-CAC for conjunctival redness (0.43 &plusmn; 0.17, P = 0.012), episcleral redness (0.49 &plusmn; 0.15, P = 0.001), mean overall redness in all regions (0.43 &plusmn; 0.15, P = 0.005), and mean chemosis (0.20 &plusmn; 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 &plusmn; 0.25, P = 0.028), conjunctival redness (0.59 &plusmn; 0.19, P = 0.002), episcleral redness (0.56 &plusmn; 0.19, P = 0.003) and mean overall redness (mean of conjunctival, episcleral, and ciliary redness, 0.59 &plusmn; 0.14, P &lt; 0.001). The mean score at 7, 15, and 20 minutes post-CAC for conjunctival redness (0.43 &plusmn; 0.17, P = 0.012), episcleral redness (0.49 &plusmn; 0.15, P = 0.001), mean overall redness in all regions (0.43 &plusmn; 0.15, P = 0.005), and mean chemosis (0.20 &plusmn; 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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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

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