Background: The clinical features of allergic ocular diseases (AOD) are characterized by their wide variety. Clinical evaluation criteria are essential not only for objective assessment in clinical trials, but also for clinical studies on etiological aspects of AOD. However, there have been no internationally established criteria for clinical evaluation and classification of the severity of AOD. We established new criteria and applied them to many cases of AOD, and evaluated their usefulness for clinical purposes. We also studied whether each clinical entity of AOD [allergic conjunctivitis (AC), atopic keratoconjunctivitis (AKC), and vernal keratoconjunctivitis (VKC)] can be distinguished by these criteria.
Methods: A prospective study was carried out to assess the differential diagnosis of 1079 patients with AOD (439 male and 640 female patients). Differential diagnosis of AC, AKC or VKC was made. These diseases were diagnosed and classified based on local and systemic clinical findings. Ten objective ocular clinical findings of conjunctival, limbal and corneal lesions were graded on a 4-point scale, and the total score, with a highest value of 30, was used as the clinical score.
Results: Among a total of 1079 cases, seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), AKC and VKC accounted for 876 (81.2%), 115 (10.6%), 47 (4.4%) and 41 (3.8%) respectively. The mean age in each disease was 52.9, 56.1, 25.7 and 16.6 years respectively. Total clinical score in SAC, PAC, AKC and VKC was 1.54, 2.13, 3.72 and 12.68 respectively. Both mean age and total clinical score in all combinations of two diseases showed significantly different results.
Conclusions: These results suggest that AOD can be classified by our new clinical grading system, and this system is sensitive enough for clinical evaluation of AOD. Re-evaluation of AOD is essential for constructing future strategies for the treatment of AOD, which are consists of various categories of ocular disorders.