Rivista di formazione e aggiornamento professionale del pediatra e del medico di base, fondata nel 1982. In collaborazione con l'Associazione Culturale Pediatri.
Login Abbonamenti Pubblicazioni Carrello Registrazione Perché registrarsi? Contatti

Ricerca

PDF

Cheratocongiuntivite primaverile (vernal)

Vernal keratoconjunctivitis

GRUPPO DI STUDIO SULLA VERNAL

Coordinamento: Rosario Cavallo, Pediatra di famiglia, Salice Salentino, Lecce; Fulvio Parentin, SC Oculistica e Strabologia, IRCCS Materno-Infantile “Burlo Garofolo”, Trieste
Pediatri di famiglia partecipanti: EMILIA ROMAGNA: Caracalla M., Gorini S., Panza C.; FRIULI VENEZIA GIULIA: Lizzi D., Ulliana A.; LAZIO: Reali L.; LOMBARDIA: Di Francesco C., Narducci M., Zanetto F.; PUGLIA: Altavilla T., Bonavota L., Casile C., Cavallo R., Chiriacò G., Cimino S., Dell'Edera L., Donno A., Giuliano B., Guacci P., Innocente M., Lisi V., Lombardo D., Peschiulli G., Petrone D., Rella F., Santoro A., Simeone G., Truppa G.; SICILIA: Amoruso B., Primavera G., Spataro A.; TOSCANA: Castelli S., Neri P.; UMBRIA: Bianchi S.; VENETO: Comacchio S., Fusco F., Matticchio G., Pasinato A., Sambugaro D.

Novembre 2013 - pagg. 578 -584

Abstract
Background - Vernal keratoconjunctivitis (VKC) is a chronic-recurrent type of conjunctivitis that may negatively affect the quality of life of patients. It is a rare disease that mainly affects the paediatric age group and tends to resolve in the pubertal age. VKC is usually disregarded both by paediatricians and ophthalmologists.
Objectives - To verify the prevalence of VKC and its management modalities in a reference population of 35,000 children and adolescents aged < 16 years by a study group of 39 Italian family paediatricians.
Methods - It is an observational study. The study group received a diagnostic protocol on VKC and other forms of conjunctivitis. During the study season the group of paediatricians highlighted all the cases of Vernal among their patients. The paediatricians specified whether the VKC diagnosis was already known or was made during the season, whether there was a reacutization during the study season or a remission and the administered therapy.
Results - 94 VKC cases were observed (34 new diagnoses and 60 cases that had been identified in the previous years), with a prevalence of 1 case/377 (26.5:10,000 patients < 16 years). The incidence of new cases / year in the assisted population is 1 case / 1,042 assisted children (9.6/10,000 children < 16 years). 59 children were treated with cortisone eye drops, 13 were treated both with cortisone and cyclosporine eye drops and 22 with cyclosporine eye drops.
Conclusions - VKC is probably a much more frequent disease than it is generally thought of. Family paediatricians can make an efficacious praecox diagnosis and, with the help of the ophthalmologists, manage and treat this pathology that is often disregarded.

Bibliografia

1. Leonardi A. Vernal keratoconjunctivitis: pathogenesis and treatment. Prog Retin Eye Res 2002;21:319-39. 2. Lambiase A, Minchiotti S, Leonardi A, et al. Prospective, multicenter demographic and epidemiological study on vernal keratoconjunctivitis: a glimpse of ocular surface in Italian population. Ophthalmic Epidemiol 2009; 16:38-41. 3. Leonardi A, Busca F, Motterle L, et al. Case series of 406 vernal keratoconjunctivitis patients: a demographic and epidemiological study. Acta Ophthalmol Scand 2006;84:406-10. 4. Pucci N, Pingitore G, Arrigoni S, et al.; Commissione Rinocongiuntivite della SIAIP. Diagnosi differenziale delle congiuntiviti allergiche. Rivista di Allergologia e Immunologia Pediatrica 2010;01:11-8. 5. Pucci N, Azzari C, Vierucci A. La cheratocongiuntivite vernal. Rivista di Immunologia e Allergologia Pediatrica 2007;2:37-44. 6. Bremond-Gignac D, Donadieu J, Leonardi A, et al. Prevalence of vernal keratoconjunctivitis: a rare disease? Br J Ophthalmol 2008; 92:1097-102. 7. European Medicines Agency. Public summary of opinion on orphan designation. Committee for Orphan Medicinal Products, 12 October 2010, EMA/COMP/1610/2003 Rev. 2, pag. 1-4. 8. Bielory L. Allergic and immunologic disorders of the eye. Part II: Ocular allergy. J Allergy Clin Immunol 2000;106:1019-32. 9. Montan PG, Ekström K, Hedlin G, van Hage-Hamsten M, Hjern A, Herrmann B. Vernal keratoconjunctivitis in a Stockholm ophthalmic centre-epidemiological, functional, and immunologic investigations. Acta Ophthalmol Scand 1999;77:559-63. 10. Bielory L, Friedlaender MH. Allergic conjunctivitis. Immunol Allergy Clin North Am 2008;28:43-58. 11. Nucci P. Tre problemi oculari da ben gestire nel prossimo decennio. Medico e Bambino 2010;29:515-8. 12. Bonini S, Bonini S, Lambiase A, et al. Vernal keratoconjunctivitis revisited: a case series of 195 patients with long-term follow up. Ophtalmology 2000;107:1157-63. 13. De Smedt S, Wildner G, Kestelyn P. Vernal keratoconjunctivitis: an update. Br J Ophthalmol 2013;97(1):9-14. 14. Bielory BP, O’Brien TP, Bielory L. Management of seasonal allergic conjunctivitis: guide to therapy. Acta Ophthalmol 2012;90: 399-407. 15. Oner V, Türkcü FM, Ta M, Alaku MF, I - can Y. Topical loteprednol etabonate 0.5% for treatment of vernal keratoconjunctivitis: efficacy and safety. Jpn J Ophthalmol 2012;56: 312-8. 16. Comstock TL, Paterno MR, Bateman KM, Decory HH, Gearinger M. Safety and tolerability of loteprednol etabonate 0.5% and tobramycin 0.3% ophthalmic suspension in pediatric subjects. Paediatr Drugs 2012;14:119- 30.

Corrispondenza: rcavallo58@gmail.com