Arquivos de Asma, Alergia e Imunologia
http://www.aaai.periodikos.com.br/article/doi/10.5935/2526-5393.20220002
Arquivos de Asma, Alergia e Imunologia
Artigo Especial

Diretriz Latino-americana sobre o Diagnóstico e Tratamento da Alergia Ocular - Em nome da Sociedade Latinoamericana de Alergia, Asma e Imunologia (SLAAI)

Latin American Guideline on the Diagnosis and Treatment of Ocular Allergy – On behalf of the Latin American Society of Allergy, Asthma and Immunology (SLAAI)

Herberto Jose Chong-Neto; Alfonso Cepeda; Ana Sofia Moreira; Andrea Leonardi; Cristine Rosário; Dirceu Solé; Elizabeth Maria Mercer Mourão; Fábio Chigres Kuschnir; Fábio Ejzembaum; Fausto Matsumoto; Francisco M. Vieira; Gennaro D'amato; German Dario Ramon; Gesmar Rodrigues Silva Segundo; Giorgio Walter Canonica; Gustavo Falbo Wandalsen; Hector Badelino; Ignácio Ansotegui; Ivan Oswaldo Tinoco; João Negreiros Tebyriçá; Jose E. Gereda; Juan Carlos Sisul Alvariza; Leonard Bielory; Luis Felipe Ensina; Maria Isabel Rojo Gutiérrez; Maria Susana Repka-Ramirez; Marilyn Urrutia Pereira; Marina Fernandes A. Cheik; Mario Sanchez Borges; Marylin Valentin Rostan; Patricia Latour Staffeld; Pedro Piraino; Raphael Coelho Figueredo; René Maximiliano Gomez; Rodrigo Rodrigues Alves; Rubén Horacio Pulido; Nelson Augusto Rosário

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Resumo

A alergia ocular, também conhecida como conjuntivite alérgica (CA), é uma reação de hipersensibilidade mediada por imunoglobulina E (IgE) do olho desencadeada por aeroalérgenos, principalmente ácaros da poeira doméstica e pólen de gramíneas. Os sintomas geralmente consistem em prurido ocular ou periocular, lacrimejamento e olhos vermelhos que podem estar presentes durante todo o ano ou sazonalmente. A alergia ocular tem frequência elevada, é subdiagnosticada e pode ser debilitante para o paciente. É potencialmente danosa para a visão, nos casos em que ocasiona cicatrização corneana grave, e na maioria dos pacientes associa-se a outros quadros alérgicos, principalmente rinite, asma e dermatite atópica. É classificada em conjuntivite alérgica perene, conjuntivite alérgica sazonal, ceratoconjuntivite atópica e ceratoconjuntivite vernal. O diagnóstico procura evidenciar o agente etiológico e a confirmação se dá pela realização do teste de provocação conjuntival. O tratamento baseia-se em evitar o contato com os desencadeantes, lubrificação, anti-histamínicos tópicos, estabilizadores de mastócitos, imunossupressores e imunoterapia específica com o objetivo de obter o controle e prevenir as complicações da doença.

Palavras-chave

Alergia ocular, conjuntivite alérgica, rinoconjuntivite.

Abstract

Ocular allergy, also known as allergic conjunctivitis, is an immunoglobulin E-mediated hypersensitivity reaction of the eye triggered by airborne allergens, primarily house dust mites and grass pollen. Symptoms usually consist of ocular or periocular itching, watery eyes, and red eyes that may be present year-round or seasonally. Ocular allergy has a high frequency, is underdiagnosed, and can be debilitating for the patient. It is potentially harmful to vision in cases of severe corneal scarring, and in most patients, it is associated with other allergic conditions, especially rhinitis, asthma, and atopic dermatitis. It is classified as perennial allergic conjunctivitis, seasonal allergic conjunctivitis, atopic keratoconjunctivitis, and vernal keratoconjunctivitis. Diagnosis seeks to identify the etiologic agent, and confirmation is given by conjunctival provocation testing. Treatment is based on avoiding contact with triggers, lubrication, topical antihistamines, mast cell stabilizers, immunosuppressants, and specific immunotherapy with the aim of achieving control and preventing disease complications.

Keywords

Ocular allergy, allergic conjunctivitis, rhinoconjunctivitis

Referências

1. Geraldini M, Neto HJC, Riedi CA, Rosário NA. Epidemiology of ocular allergy and co-morbidities in adolescents. J Pediatr (Rio J.). 2013;89:354-60. doi: 10.1016/j.jped.2013.01.001.

2. Dinowitz M, Rescigno R, Bielory L. Ocular Allergic Diseases: Differential Diagnosis, Examination Techniques and Testing. In: Kemp SF, Lockey RF, eds. Diagnostic Testing of Allergic Disease, vol. 1. 1ª ed. Basel: Marcel Dekker eds.; 2000. p. 127-50.

3. Shoji J. Ocular allergy test and biomarkers on the ocular surface: Clinical test for evaluating the ocular surface condition in allergic conjunctival diseases. Allergology International. 2020;69:496-504. doi: 10.1016/j.alit.2020.05.003.

4. Dupuis P, Prokopich CL, Hynes A, Kim H. A contemporary look at allergic conjunctivitis. Allergy Asthma Clin Immunol. 2020;16:5. doi: 10.1186/s13223-020-0403-9.

5. Kuruvilla M, Kalangara J, Eun-Hyung Lee F. Neuropathic Pain and Itch Mechanisms Underlying Allergic Conjunctivitis. J Investig Allergol Clin Immunol. 2019;29(5):349-56. doi: 10.18176/jiaci.0320.

6. Meng X-T, Shi Y-Y, Zhang H, Zhou H-Y. The Role of Th17 Cells and IL-17 in Th2 Immune Responses of Allergic Conjunctivitis. Journal of Ophthalmology. 2020;2020:1-9. doi: 10.1155/2020/6917185.

7. Bielory L, Delgado L, Katelaris CH, Leonardi A, Rosario N, Vichyanoud P. ICON. Ann Allergy Asthma Immunol. 2020;124:118-34. doi: 10.1016/j.anai.2019.11.014.

8. Gelardi M, Leo ME, Quaranta VN, Iannuzzi L, Tripodi S, Quaranta N, et al. Clinical characteristics associated with conjunctival inflammation in allergic rhinoconjunctivitis. J Allergy Clin Immunol Pract. 2015;3(3):387-91.e1. doi: 10.1016/j.jaip.2015.01.006.

9. Leonardi A, Castegnaro A, Valerio ALG, Lazzarini D. Epidemiology of allergic conjunctivitis. Curr Opin Allergy Clin Immunol. 2015;15:482-8. doi: 10.1097/ACI.0000000000000204.

10. Hesselmar B, Åberg B, Eriksson B, Åberg N. Allergic rhinoconjunctivitis, eczema, and sensitization in two areas with differing climates. Pediatr Allergy Immunol. 2001;12:208-15. doi: 10.1034/j.1399-3038.2001.012004208.x.

11. Rosário CS, Cardozo CA, Chong-Neto HJ, Chong-Silva DC, Riedi CA, Rosario-Filho NA. Understanding eye allergy. Arq Asma Alerg Imunol. 2020;4(1):78-84. doi: 10.5935/2526-5393.20200006.

12. Bonini S, Coassin M, Aronni S, Lambiase A. Vernal keratoconjunctivitis. Eye. 2004;18:345-51. doi: 10.1038/sj.eye.6700675.

13. Marback PMF, Freitas D de, Paranhos Junior A, Belfort Junior R. Aspectos clínicos e epidemiológicos da conjuntivite alérgica em serviço de referência. Arquivos Brasileiros de Oftalmologia. 2007;70:312-6. doi: 10.1590/S0004-27492007000200022.

14. Bousquet J, Anto JM, Akdis M, Auffray C, Keil T, Momas I, et al. Paving the way of systems biology and precision medicine in allergic diseases: the Me DALL success story. Allergy. 2016;71:1513-25. doi: 10.1111/all.12880.

15. Abelson MB, Schaefer K. Conjunctivitis of allergic origin: Immunologic mechanisms and current approaches to therapy. Survey of Ophthalmology. 1993;38:115-32. doi: 10.1016/0039-6257(93)90036-7.

16. Bielory L. Differential diagnoses of conjunctivitis for clinical allergist-immunologists. Ann Allergy Asthma Immunol. 2007;98:105-15. doi: 10.1016/S1081-1206(10)60681-3.

17. Rosario Filho NA. Reflexões sobre polinose: 20 anos de experiência. Rev Bras Alergia Imunopatol.1997;20:210-3.

18. Vieira FAM. Polinose no Brasil. In: Negreiros B, Unguier C, eds. Alergologia Clínica, vol. I. 1ª ed. Rio de Janeiro: Atheneu; 1995. p. 106-11.

19. Vieira FM, Motta VT. Conjuntivite alérgica polínica em Caxias do Sul, Brasil. Rev Bras Alerg Imunopatol. 2007;31:56-9.

20. Geller-Bernstein C, Portnoy JM. The Clinical Utility of Pollen Counts. Clin Rev Allergy Immunol. 2019;57(3):340-349. doi: 10.1007/s12016-018-8698-8.

21. Bianchi MM, Olabuenaga SE. A 3-year airborne pollen and fungal spores record in San Carlos de Bariloche, Patagonia, Argentina. Aerobiologia. 2006;22:247-57. doi: 10.1007/s10453-006-9037-8.

22. Charpin D, Pichot C, Belmonte J, Sutra J-P, Zidkova J, Chanez P, et al. Cypress Pollinosis: from Tree to Clinic. Clin Rev Allergy Immunol. 2019;56:174-95. doi: 10.1007/s12016-017-8602-y.

23. Núñez R, Carballada F, Lombardero M, Jimeno L, Boquete M. Profilin as an Aeroallergen by Means of Conjunctival Allergen Challenge with Purified Date Palm Profilin. Int Arch Allergy Immunol. 2012;158:115-9. doi: 10.1159/000330822.

24. Pendino P, Agüero C, Cavagnero P, Lopez K, Kriunis I, Molinas J. Aeroallergen sensitization in wheezing children from Rosario, Argentina. World Allergy Organ J. 2011;4:159-63. doi: 10.1097/WOX.0b013e318232df96.

25. Ramon G, Bronfen S, Villamil C, Ferrerlic N, Apphatie S, Barzon S. 1025 Relevant pollens in the etiology of seasonal allergic rhinitis in the city of Bahía Blanca (Argentina) and its surrounding area. J Allergy Clinic Immunol. 1996;97:439. doi: 10.1016/S0091-6749(96)81243-7.

26. Murray MG, Galán C. Effect of the meteorological parameters on the Olea europaea L. pollen season in Bahía Blanca (Argentina). Aerobiologia. 2016;32:541-53. doi: 10.1007/s10453-016-9431-9.

27. Pajarón MJ, Vila L, Prieto I, Resano A, Sanz ML, Oehling AK. Cross-reactivity of Olea europaea with other Oleaceae species in allergic rhinitis and bronchial asthma. Allergy. 1997;52:829-35. doi: 10.1111/j.1398-9995.1997.tb02154.x.

28. Heinzerling L, Frew AJ, Bindslev-Jensen C, Bonini S, Bousquet J, Bresciani M, et al. Standard skin prick testing and sensitization to inhalant allergens across Europe - a survey from the GA2LEN network*. Allergy. 2005;60:1287-300. doi: 10.1111/j.1398-9995.2005.00895.x.

29. Cariñanos P, Ruiz-Peñuela S, Valle AM, de la Guardia CD. Assessing pollination disservices of urban street-trees: The case of London-plane tree (Platanus x hispanica Mill. ex Münchh). Sci Total Environ. 2020 Oct 1;737:139722. doi: 10.1016/j.scitotenv.2020.139722.

30. Balugo Lopez V, Hernandez Garcıa de la Barrena E. Relevance of Clinical Sensitization to Quercus Pollen in Spain? J Allergy Clin Immunol. 2016;137(2 Suppl):AB122. doi: 10.1016/j.jaci.2015.12.528.

31. Ramon GD, Arango N, Barrionuevo LB, Reyes MS, Adamo M, Molina O, et al. Comparison of Grass Pollen Levels in 5 Cities of Argentina. J Allergy Clin Immunol. 2016;137(2 Suppl):AB122. doi: 10.1016/j.jaci.2015.12.530.

32. Ramon GD, Barrionuevo LB, Viego V, Vanegas E, Felix M, Cherrez-Ojeda I. Sensitization to subtropical grass pollens in patients with seasonal allergic rhinitis from Bahia Blanca, Argentina. World Allergy Organ J. 2019 Sep 30;12(9):100062. doi: 10.1016/j.waojou.2019.100062.

33. Ramón GD, Croce VH, Chérrez Ojeda I. Anaphylaxis in a 4-year-old male caused by contact with grasses: a case report. World Allergy Organ J. 2017;10:5. doi: 10.1186/s40413-016-0133-0.

34. Marcó LN, Pirovani M. Relevamiento de flora alergógena en Concepción del Uruguay. Arch alerg inmunol clin. 2009;40(2):44-50.

35. Chang C-J, Yang H-H, Chang C-A, Tsai H-Y. Relationship between Air Pollution and Outpatient Visits for Nonspecific Conjunctivitis. Invest Ophthalmol Vis Sci. 2012;53:429-33. doi: 10.1167/iovs.11-8253.

36. Sun Z, Zhu D. Exposure to outdoor air pollution and its human health outcomes: A scoping review. Plos One. 2019;14:e0216550. doi: 10.1371/journal.pone.0216550.

37. Schraufnagel DE, Balmes JR, Cowl CT, de Matteis S, Jung S-H, Mortimer K, et al. Air Pollution and Noncommunicable Diseases. Chest. 2019;155:409-16. doi: 10.1016/j.chest.2018.10.042.

38. Łatka P, Nowakowska D, Nowomiejska K, Rejdak R. How air pollution affects the eyes - a review. Ophthalmology Journal. 2018;3:58-62. doi: 10.5603/OJ.2018.0032.

39. Fujishima H, Satake Y, Okada N, Kawashima S, Matsumoto K, Saito H. Effects of diesel exhaust particles on primary cultured healthy human conjunctival epithelium. Ann Allergy Asthma Immunol. 2013;110:39-43. doi: 10.1016/j.anai.2012.10.017.

40. Novaes P, do Nascimento Saldiva PH, Kara-José N, Macchione M, Matsuda M, Racca L, et al. Ambient Levels of air pollution induce goblet-cell hyperplasia in human conjunctival epithelium. Environ Health Perspect. 2007;115:1753-6. doi: 10.1289/ehp.10363.

41. Miyazaki D, Fukagawa K, Fukushima A, Fujishima H, Uchio E, Ebihara N, et al. Air pollution significantly associated with severe ocular allergic inflammatory diseases. Scientific Reports. 2019;9:18205. doi: 10.1038/s41598-019-54841-4.

42. Lee H, Kim EK, Kim HY, Kim T. Effects of exposure to ozone on the ocular surface in an experimental model of allergic conjunctivitis. Plos One. 2017;12:e0169209. doi: 10.1371/journal.pone.0169209.

43. Nucci P, Sacchi M, Pichi F, Allegri P, Serafino M, dello Strologo M, et al. Pediatric conjunctivitis and air pollution exposure: a prospective observational study. Seminars in Ophthalmology. 2017;32:407-11. doi: 10.3109/08820538.2015.1115088.

44. Zhong J-Y, Lee Y-C, Hsieh C-J, Tseng C-C, Yiin L-M. Association between the first occurrence of allergic conjunctivitis, air pollution and weather changes in Taiwan. Atmospheric Environment. 2019;212:90-5. doi: 10.1016/j.atmosenv.2019.05.045.

45. Lee J-Y, Kim J-W, Kim E-J, Lee M-Y, Nam C-W, Chung I-S. Spatial analysis between particulate matter and emergency room visits for conjunctivitis and keratitis. Ann Occup Environ Med. 2018;30:41. doi: 10.1186/s40557-018-0252-x.

46. Mimura T, Ichinose T, Yamagami S, Fujishima H, Kamei Y, Goto M, et al. Airborne particulate matter (PM2.5) and the prevalence of allergic conjunctivitis in Japan. Science of The Total Environment. 2014;487:493-9. doi: 10.1016/j.scitotenv.2014.04.057.

47. Fu Q, Mo Z, Lyu D, Zhang L, Qin Z, Tang Q, et al. Air pollution and outpatient visits for conjunctivitis: A case-crossover study in Hangzhou, China. Environmental Pollution. 2017;231:1344-50. doi: 10.1016/j.envpol.2017.08.109.

48. Bourcier T. Effects of air pollution and climatic conditions on the frequency of ophthalmological emergency examinations. Br J Ophthalmol. 2003;87:809-11. doi: 10.1136/bjo.87.7.809.

49. Chen R, Yang J, Zhang C, Li B, Bergmann S, Zeng F, Wang H, Wang B. Global Associations of Air Pollution and Conjunctivitis Diseases: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2019 Sep 28;16(19):3652. doi: 10.3390/ijerph16193652.

50. Abusharha AA, Pearce EI. The Effect of Low Humidity on the Human Tear Film. Cornea. 2013;32:429-34. doi: 10.1097/ICO.0b013e31826671ab.

51. Stapleton F, Alves M, Bunya VY, Jalbert I, Lekhanont K, Malet F, et al. TFOS DEWS II Epidemiology Report. The Ocular Surface. 2017;15:334-65. doi: 10.1016/j.jtos.2017.05.003.

52. Gao Z-X, Song X-L, Li S-S, Lai X-R, Yang Y-L, Yang G, et al. Assessment of DNA Damage and Cell Senescence in Corneal Epithelial Cells Exposed to Airborne Particulate Matter (PM2.5) Collected in Guangzhou, China. Invest Ophthalmol Vis Sci. 2016;57:3093. doi: 10.1167/iovs.15-18839.

53. Chen R, Hu B, Liu Y, Xu J, Yang G, Xu D, et al. Beyond PM2.5: The role of ultrafine particles on adverse health effects of air pollution. Biochim Biophys Acta. 2016;1860:2844-55. doi: 10.1016/j.bbagen.2016.03.019.

54. Li J, Tan G, Ding X, Wang Y, Wu A, Yang Q, et al. A mouse dry eye model induced by topical administration of the air pollutant particulate matter 10. Biomedicine & Pharmacotherapy. 2017;96:524-34. doi: 10.1016/j.biopha.2017.10.032.

55. Singh P, Tyagi M, Kumar Y, Gupta K, Sharma P. Ocular chemical injuries and their management. Oman Journal of Ophthalmology. 2013;6:83. doi: 10.4103/0974-620X.116624.

56. Callejo G, Castellanos A, Castany M, Gual A, Luna C, Acosta MC, et al. Acid-sensing ion channels detect moderate acidifications to induce ocular pain. Pain. 2015;156:483-95. doi: 10.1097/01.j.pain.0000460335.49525.17.

57. Chang C-J, Yang H-H, Chang C-A, Tsai H-Y. Relationship between Air Pollution and Outpatient Visits for Nonspecific Conjunctivitis. Invest Ophthalmol Vis Sci. 2012;53:429. doi: 10.1167/iovs.11-8253.

58. Baïz N, Slama R, Béné M-C, Charles M-A, Kolopp-Sarda M-N, Magnan A, et al. Maternal exposure to air pollution before and during pregnancy related to changes in newborn's cord blood lymphocyte subpopulations. The EDEN study cohort. BMC Pregnancy and Childbirth. 2011;11:87. doi: 10.1186/1471-2393-11-87.

59. Zhang X, M VJ, Qu Y, He X, Ou S, Bu J, et al. Dry eye management: targeting the ocular surface microenvironment. Int J Mol Sci. 2017;18:1398. doi: 10.3390/ijms18071398.

60. Hwang SH, Choi Y-H, Paik HJ, Wee WR, Kim MK, Kim DH. Potential importance of ozone in the association between outdoor air pollution and dry eye disease in South Korea. JAMA Ophthalmology. 2016;134:503. doi: 10.1001/jamaophthalmol.2016.0139.

61. Saxena R, Srivastava S, Trivedi D, Anand E, Joshi S, Gupta SK. Impact of environmental pollution on the eye. Acta Ophthalmologica Scandinavica. 2003;81:491-4. doi: 10.1034/j.1600-0420.2003.00119.x.

62. Malerbi FK, Martins LC, Saldiva PHN, Braga ALF. Ambient levels of air pollution induce clinical worsening of blepharitis. Environmental Research. 2012;112:199-203. doi: 10.1016/j.envres.2011.11.010.

63. Ravilla TD, Gupta S, Ravindran RD, Vashist P, Krishnan T, Maraini G, et al. Use of Cooking Fuels and Cataract in a Population-Based Study: The India Eye Disease Study. Environ Health Perspect. 2016;124:1857-62. doi: 10.1289/EHP193.

64. Pokhrel AK, Smith KR, Khalakdina A, Deuja A, Bates MN. Case-control study of indoor cooking smoke exposure and cataract in Nepal and India. Int J Epidemiol. 2005;34:702-8. doi: 10.1093/ije/dyi015.

65. Adar SD, Klein R, Klein BEK, Szpiro AA, Cotch MF, Wong TY, et al. Air Pollution and the Microvasculature: A Cross-Sectional Assessment of In Vivo Retinal Images in the Population-Based Multi-Ethnic Study of Atherosclerosis (MESA). PLoS Medicine. 2010;7:e1000372. doi: 10.1371/journal.pmed.1000372.

66. Louwies T, Panis LI, Kicinski M, de Boever P, Nawrot TS. Retinal Microvascular Responses to Short-Term Changes in Particulate Air Pollution in Healthy Adults. Environ Health Perspect. 2013;121:1011-6. doi: 10.1289/ehp.1205721.

67. Cortés-Morales G, Velasco-Medina AA, Arroyo-Cruz ME, Velázquez-Sámano G. Frecuencia de sensibilización a aeroalergenos en pacientes con conjuntivitis alérgica estacional y perenne [Frequency of sensitization to aeroallergens in patients with seasonal and perennial allergic conjunctivitis]. Rev Alerg Mex. 2014 Jul-Sep;61(3):141-6.

68. Singh K, Axelrod S, Bielory L. The epidemiology of ocular and nasal allergy in the United States, 1988-1994. J Allergy Clin Immunol. 2010 Oct;126(4):778-83.e6. doi: 10.1016/j.jaci.2010.06.050.

69. Ojeda P, Sastre J, Olaguibel JM, Chivato T; investigators participating in the National Survey of the Spanish Society of Allergology and Clinical Immunology Alergológica 2015. Alergológica 2015: A National Survey on Allergic Diseases in the Adult Spanish Population. J Investig Allergol Clin Immunol. 2018 Jun;28(3):151-64. doi: 10.18176/jiaci.0264.

70. Feng Y, Wang X, Wang F, Liu R, Chen L, Wu S, et al. The Prevalence of Ocular Allergy and Comorbidities in Chinese School Children in Shanghai. Biomed Res Int. 2017;2017:1-11. doi: 10.1155/2017/7190987.

71. Stahl JL, Barney NP. Ocular allergic disease. Curr Opin Allergy Clin Immunol. 2004;4:455-9. doi: 10.1097/00130832-200410000-00020.

72. Weeke ER. Epidemiology of hay fever and perennial allergic rhinitis. Monographs in Allergy. 1987;21:1-20.

73. Leonardi A, Bogacka E, Fauquert JL, Kowalski ML, Groblewska A, Jedrzejczak-Czechowicz M, et al. Ocular allergy: recognizing and diagnosing hypersensitivity disorders of the ocular surface. Allergy. 2012;67:1327-37. doi: 10.1111/all.12009.

74. Chong Neto HJ, Rosário NA. Studying specific IgE: in vivo or in vitro. Allergologia et Immunopathologia. 2009;37:31-5. doi: 10.1016/S0301-0546(09)70249-6.

75. Willumsen N, Holm J, Christensen LH, Würtzen PA, Lund K. The complexity of allergic patients' IgE repertoire correlates with serum concentration of allergen-specific IgE. Clin Exp Allergy. 2012;42:1227-36. doi: 10.1111/j.1365-2222.2012.04009.x.

76. Melioli G, Passalacqua G, Canonica GW, Baena-Cagnani CE, Matricardi P. Component-resolved diagnosis in pediatric allergic rhinoconjunctivitis and asthma. Curr Opin Allergy Clin Immunol. 2013;13:446-51. doi: 10.1097/ACI.0b013e32836274d8.

77. Melioli G, Bonifazi F, Bonini S, Maggi E, Mussap M, Passalacqua G, et al. The ImmunoCAP ISAC molecular allergology approach in adult multi-sensitized Italian patients with respiratory symptoms. Clinical Biochemistry. 2011;44:1005-11. doi: 10.1016/j.clinbiochem.2011.05.007.

78. Rossi RE, Monasterolo G, Operti D, Operti R, Berlen R. Evaluation of IgE antibodies to recombinant pollen allergens(Phl p 1, Phl p 2, and Phl p 5) in a random sample of patients withspecific IgE to Phleum pratense. Allergy. 2000;55:181-4. doi: 10.1034/j.1398-9995.2000.00320.x.

79. Jung JH, Kang IG, Kim ST. Comparison of Component-Resolved Diagnosis by Using Allergen Microarray With the Conventional Tests in Allergic Rhinitis Patients: The First Using in Korea. Clinical and Experimental Otorhinolaryngology. 2015;8:385. doi: 10.3342/ceo.2015.8.4.385.

80. Santosa A, Andiappan AK, Rotzschke O, Wong HC, Chang A, Bigliardi Qi M, et al. Evaluation of the applicability of the Immuno solid phase allergen chip (ISAC) assay in atopic patients in Singapore. Clin Transl Allergy. 2015;5:9. doi: 10.1186/s13601-015-0053-z.

81. Prosperi MCF, Belgrave D, Buchan I, Simpson A, Custovic A. Challenges in interpreting allergen microarrays in relation to clinical symptoms: A machine learning approach. Pediatr Allergy Immunol. 2014;25:71-9. doi: 10.1111/pai.12139.

82. Bonini M, Marcomini L, Gramiccioni C, Tranquilli C, Melioli G, Canonica GW, et al. Microarray evaluation of specific IgE to allergen components in elite athletes. Allergy. 2012:n/a-n/a. doi: 10.1111/all.12029.

83. Panzner P, Vachová M, Vítovcová P, Brodská P, Vlas T. A Comprehensive Analysis of Middle-European Molecular Sensitization Profiles to Pollen Allergens. Int Arch Allergy Immunol. 2014;164:74-82. doi: 10.1159/000362760.

84. Cabrera-Freitag P, Goikoetxea MJ, Beorlegui C, Gamboa P, Gastaminza G, Fernández-Benítez M, et al. Can component-based microarray replace fluorescent enzimoimmunoassay in the diagnosis of grass and cypress pollen allergy? Clin Exp Allergy. 2011;41:1440-6. doi: 10.1111/j.1365-2222.2011.03818.x.

85. Ahlgrim C, Gutermuth J, Onell A, Borres MP, Schäffner I, Darsow U, et al. Comparison of Molecular Multiplex and Singleplex Analysis of IgE to Grass Pollen Allergens in Untreated German Grass Pollen-Allergic Patients. J Investig Allergol Clin Immunol. 2015;25:190-5.

86. Araujo LML, Rosario NA, Mari A. Molecular-based diagnosis of respiratory allergic diseases in children from Curitiba, a city in Southern Brazil. Allergologia et Immunopathologia. 2016;44:18-22. doi: 10.1016/j.aller.2015.03.001.

87. Zeng G, Luo W, Zheng P, Wei N, Huang H, Sun B, et al. Component-Resolved Diagnostic Study of Dermatophagoides Pteronyssinus Major Allergen Molecules in a Southern Chinese Cohort. J Investig Allergol Clin Immunol. 2015;25:343-51.

88. Bronnert M, Mancini J, Birnbaum J, Agabriel C, Liabeuf V, Porri F, et al. Component-resolved diagnosis with commercially available D. pteronyssinus Der p 1, Der p 2 and Der p 10: relevant markers for house dust mite allergy. Clin Exp Allergy. 2012;42:1406-15. doi: 10.1111/j.1365-2222.2012.04035.x.

89. Nieto M, Lafuente I, Calderon R, Uixera S, Pina R, Calaforra S, et al. Component-resolved diagnosis: Performance of specific IgE to Alternaria compared to Alt a 1. Pediatr Allergy Immunol. 2014;25:832-4. doi: 10.1111/pai.12305.

90. Liccardi G, Bilò MB, Manzi F, Piccolo A, di Maro E, Salzillo A. What could be the role of molecular-based allergy diagnostics in detecting the risk of developing allergic sensitization to furry animals? Eur Ann Allergy Clin Immunol. 2015;47:163-7.

91. Asarnoj A, Hamsten C, Wadén K, Lupinek C, Andersson N, Kull I, et al. Sensitization to cat and dog allergen molecules in childhood and prediction of symptoms of cat and dog allergy in adolescence: A BAMSE/MeDALL study. J Allergy Clin Immunol. 2016;137:813-821.e7. doi: 10.1016/j.jaci.2015.09.052.

92. Westman M, Lupinek C, Bousquet J, Andersson N, Pahr S, Baar A, et al. Early childhood IgE reactivity to pathogenesis-related class 10 proteins predicts allergic rhinitis in adolescence. J Allergy Clin Immunol. 2015;135:1199-1206.e11. doi: 10.1016/j.jaci.2014.10.042.

93. Hatzler L, Panetta V, Lau S, Wagner P, Bergmann RL, Illi S, et al. Molecular spreading and predictive value of preclinical IgE response to Phleum pratense in children with hay fever. J Allergy Clin Immunol. 2012;130:894-901.e5. doi: 10.1016/j.jaci.2012.05.053.

94. Baye A, Batellier L, Doan S, Bury T, Vitte J. Multiplex assay of specific IgE antibodies in tear fluids by means of microarray technology. Journal Français d'Ophtalmologie. 2016;39:e183-5. doi: 10.1016/j.jfo.2015.10.012.

95. Leonardi A, Borghesan F, Faggian D, Plebani M. Microarray-based IgE detection in tears of patients with vernal keratoconjunctivitis. Pediatr Allergy Immunol. 2015;26:641-5. doi: 10.1111/pai.12450.

96. Agache I, Bilò M, Braunstahl G-J, Delgado L, Demoly P, Eigenmann P, et al. In vivo diagnosis of allergic diseases-allergen provocation tests. Allergy. 2015;70:355-65. doi: 10.1111/all.12586.

97. Abelson MB, Chambers WA, Smith LM. Conjunctival allergen challenge. A clinical approach to studying allergic conjunctivitis. Arch Ophthalmol. 1990 Jan;108(1):84-8. doi: 10.1001/archopht.1990.01070030090035.

98. Friedlaender MH. Management of ocular allergy. Ann Allergy Asthma Immunol. 1995;75:212-22; quiz 223-4.

99. Fauquert J-L, Jedrzejczak-Czechowicz M, Rondon C, Calder V, Silva D, Kvenshagen BK, et al. Conjunctival allergen provocation test : guidelines for daily practice. Allergy. 2017;72:43-54. doi: 10.1111/all.12986.

100. Mortemousque B, Fauquert JL, Chiambaretta F, Demoly P, Helleboid L, Creuzot-Garcher C, et al. Le test de provocation conjonctival : recommandations pratiques pour le diagnostic des conjonctivites allergiques. Journal Français d'Ophtalmologie. 2006;29:837-46. doi: 10.1016/S0181-5512(06)73857-8.

101. Mourão EMM, Rosário Filho NA. Teste de provocação conjuntival com alérgenos no diagnóstico de conjuntivite alérgica. Rev Bras Alerg Immunopatol. 2011;34:90-6.

102. Leonardi A, Fregona IA, Gismondi M, Daniotti E, Carniel G, Secchi AG. Correlation between conjunctival provocation test (CPT) and systemic allergometric tests in allergic conjunctivitis. Eye. 1990;4:760-4. doi: 10.1038/eye.1990.109.

103. Leonardi A, Battista MC, Gismondi M, Fregona IA, Secchi AG. Antigen sensitivity evaluated by tear-specific and serum-specific IgE, skin tests, and conjunctival and nasal provocation tests in patients with ocular allergic disease. Eye. 1993;7:461-4. doi: 10.1038/eye.1993.93.

104. Leonardi A, Doan S, Fauquert JL, Bozkurt B, Allegri P, Marmouz F, et al. Diagnostic tools in ocular allergy. Allergy. 2017;72:1485-98. doi: 10.1111/all.13178.

105. Montan PG, van Hage-Hamsten M, Zetterström O. Sustained eosinophil cationic protein release into tears after a single high-dose conjunctival allergen challenge. Clin Exp Allergy. 1996;26:1125-30.

106. Abelson MB, Greiner JV. Comparative efficacy of olopatadine 0.1% ophthalmic solution versus levocabastine 0.05% ophthalmic suspension using the conjunctival allergen challenge model. Current Medical Research and Opinion. 2004;20:1953-8. doi: 10.1185/030079904X5724.

107. Krane Kvenshagen B, Jacobsen M, Halvorsen R. Can conjunctival provocation test facilitate the diagnosis of food allergy in children? Allergologia et Immunopathologia. 2010;38:321-6. doi: 10.1016/j.aller.2010.01.007.

108. Möller C, Björksten B, Nilsson G, Dreborg S. The Precision of the Conjunctival Provocation Test. Allergy. 1984;39:37-41. doi: 10.1111/j.1398-9995.1984.tb01931.x.

109. Bonini S, Bonini S, Bucci MG, Berruto A, Adriani E, Balsano F, et al. Allergen dose response and late symptoms in a human model of ocular allergy. J Allergy Clin Immunol. 1990;86:869-76. doi: 10.1016/S0091-6749(05)80148-4.

110. Leonardi A, Motterle L, Bortolotti M. Allergy and the eye. Clin Exp Immunol. 2008;153:17-21. doi: 10.1111/j.1365-2249.2008.03716.x.

111. Núñez JA, Cuesta U. Local conjunctival immunotherapy: the effect of dermatophagoides pteronyssinus local conjunctival immunotherapy on conjunctival provocation test in patients with allergic conjunctivitis. Allergol Immunopathol (Madr). 2000 Nov-Dec;28(6):301-6.

112. Mourão EMM, Rosário NA, Silva L, Shimakura SE. Ocular symptoms in nonspecific conjunctival hyperreactivity. Ann Allergy Asthma Immunol. 2011;107:29-34. doi: 10.1016/j.anai.2011.03.002.

113. Mourão EMM, Rosário NA. Adverse reactions to the allergen conjunctival provocation test. Ann Allergy Asthma Immunol. 2011;107:373-4. doi: 10.1016/j.anai.2011.07.015.

114. Anderson DF, McGill JI, Roche WR. Improving the safety of conjunctival provocation tests. J Allergy Clin Immunol. 1996;98:1000. doi: 10.1016/S0091-6749(96)80022-4.

115. Rodrigues J, Kuruvilla ME, Vanijcharoenkarn K, Patel N, Hom MM, Wallace D v. The spectrum of allergic ocular diseases. Ann Allergy Asthma Immunol. 2021;126:240-54. doi: 10.1016/j.anai.2020.11.016.

116. Tangye SG, Al-Herz W, Bousfiha A, Chatila T, Cunningham-Rundles C, Etzioni A, et al. Human Inborn Errors of Immunity: 2019 Update on the Classification from the International Union of Immunological Societies Expert Committee. J Clin Immunol. 2020;40:24-64. doi: 10.1007/s10875-019-00737-x.

117. Hosseinverdi S, Hashemi H, Aghamohammadi A, Ochs HD, Rezaei N. Ocular Involvement in Primary Immunodeficiency Diseases. J Clin Immunol. 2014;34:23-38. doi: 10.1007/s10875-013-9974-2.

118. Klotz SA, Penn CC, Negvesky GJ, Butrus SI. Fungal and Parasitic Infections of the Eye. Clinical Microbiology Reviews. 2000;13:662-85. doi: 10.1128/CMR.13.4.662.

119. Franklin RM, Winkelstein JA, Seto DSY. Conjunctivitis and Keratoconjunctivitis Associated with Primary Immunodeficiency Diseases. Am J Ophthalmol. 1977;84:563-6. doi: 10.1016/0002-9394(77)90453-6.

120. Boone WB, O'Reilly RJ, Pahwa S, Grimes E, Smithwick EM, Good RA. Acquired CMV chorioretinitis in severe combined immunodeficiency. Clin Immunol Immunopathol. 1978;9:129-33. doi: 10.1016/0090-1229(78)90129-0.

121. Perren BA, Raisanen J, Good WV, Crawford JB. Cytomegalovirus retinitis and optic neuritis in a child with severe combined immunodeficiency syndrome. Retina. 1996;16:117-21. doi: 10.1097/00006982-199616020-00005.

122. Baumal CR, Levin A v, Read SE. Cytomegalovirus retinitis in immunosuppressed children. Am J Ophthalmol. 1999;127:550-8. doi: 10.1016/S0002-9394(99)00031-8.

123. al Ghonaium A, Ziegler JB, Tridgell D. Bilateral chronic conjunctivitis and corneal scarring in a boy with X-linked hypogammaglobulinaemia. J Paediatr Child Health. 1996 Oct;32(5):463-5. doi: 10.1111/j.1440-1754.1996.tb00950.x.

124. Hansel TT, O'Neill DP, Yee ML, Gibson JM, Thompson RA. Infective conjunctivitis and corneal scarring in three brothers with sex linked hypogammaglobulinaemia (Bruton's disease). Br J Ophthalmol. 1990;74:118-20. doi: 10.1136/bjo.74.2.118.

125. Ooi KG-J, Joshua F, Broadfoot A. Recurrent multi-organism keratoconjunctivitis manifesting as a first presentation of common variable immune deficiency (CVID). Ocul Immunol Inflamm. 2007;15:403-5. doi: 10.1080/09273940701486449.

126. Chao J, Yumei Z, Zhiqun W, Yang Z, Xuguang S. Multidrug-resistant bacteria induce recurrent keratoconjunctivitis in a patient with common variable immunodeficiency. Cornea. 2013;32:S39-42. doi: 10.1097/ICO.0b013e3182a2c7e6.

127. Christensen L, McDonnell JT, Singh J. Ocular manifestations of allergic and immunologic diseases. In: Levin AV, Enzenauer RW, eds. The Eye in Pediatric Systemic Disease. Cham: Springer International Publishing; 2017. p. 51-78. doi: 10.1007/978-3-319-18389-3_3.

128. Aghamohammadi A, Cheraghi T, Gharagozlou M, Movahedi M, Rezaei N, Yeganeh M, et al. IgA Deficiency: Correlation Between Clinical and Immunological Phenotypes. J Clin Immunol. 2009;29:130-6. doi: 10.1007/s10875-008-9229-9.

129. Kıratlı HK, Akar Y. Multiple recurrent hordeola associated with selective IgM deficiency. J AAPOS. 2001;5:60-1. doi: 10.1067/mpa.2001.111018.

130. Palestine AG, Meyers SM, Fauci AS, Gallin JI. Ocular Findings in patients with Neutrophil Dysfunction. Am J Ophthalmol. 1983;95:598-604. doi: 10.1016/0002-9394(83)90377-X.

131. Grossniklaus HE, Frank EK, Jacobs G. Chorioretinal lesions in chronic granulomatous disease of childhood. Retina. 1988;8:270-4. doi: 10.1097/00006982-198808040-00009.

132. Panagiotopoulos M, Sönne H. Chronic granulomatous disease and serious unilateral keratitis with bilateral conjunctivitis: a rare case of external ocular disease. Acta Ophthalmologica. 2011;89:e296-7. doi: 10.1111/j.1755-3768.2009.01858.x.

133. Matsuura T, Sonoda K-H, Ohga S, Ariyama A, Nakamura T, Ishibashi T. A Case of Chronic Recurrent Uveitis Associated with Chronic Granulomatous Disease. Japanese Journal of Ophthalmology. 2006;50:287-9. doi: 10.1007/s10384-005-0313-x.

134. Kavehmanesh Z, Matinzadeh ZK, Amirsalari S, Torkaman M, Afsharpayman S, Javadipour M. Leukocyte adhesion deficiency: report of two family related newborn infants. Acta Medica Iranica. n.d.;48:273-6.

135. Ganesh A, Al-Zuhaibi SS, Bialasiewicz AA, Al-Abri R, Ahmed S, Al-Tamemi S, et al. Necrotizing Pseudomonas infection of the ocular adnexa in an infant with leukocyte adhesion defect. J Pediatr Ophthalmol Strabismus. 2007 Jul-Aug;44(4):199-200. doi: 10.3928/01913913-20070701-09.

136. Chang B, Brosnahan D, McCreery K, Dominguez M, Costigan C. Ocular complications of autoimmune polyendocrinopathy syndrome type 1. J AAPOS. 2006 Dec;10(6):515-20. doi: 10.1016/j.jaapos.2006.06.018.

137. Carboni I, Soda R, Bianchi L, Chimenti S. Chronic Mucocutaneous Candidiasis and Alopecia Areata as Cutaneous Expressions of Autoimmune Polyglandular Syndrome Type I. Acta Dermato-Venereologica. 2002;82:68-9. doi: 10.1080/000155502753600993.

138. Rescigno R, Dinowitz M. Ophthalmic manifestations of immunodeficiency states. Clin Rev Allergy Immunol. 2001;20:163-81. doi: 10.1007/s12016-001-0001-7.

139. Grønskov K, Ek J, Brondum-Nielsen K. Oculocutaneous albinism. Orphanet Journal of Rare Diseases. 2007;2:43. doi: 10.1186/1750-1172-2-43.

140. Moin M, Aghamohammadi A, Kouhi A, Tavassoli S, Rezaei N, Ghaffari S-R, et al. Ataxia-Telangiectasia in Iran: Clinical and Laboratory Features of 104 Patients. Pediatric Neurology. 2007;37:21-8. doi: 10.1016/j.pediatrneurol.2007.03.002.

141. Bhisitkul RB. Bloom syndrome: multiple retinopathies in a chromosome breakage disorder. Br J Ophthalmol. 2004;88:354-7. doi: 10.1136/bjo.2002.011643.

142. Podos SM, Einaugler RB, Albert DM, Blaese RM. Ophthalmic Manifestations of the Wiskott-Aldrich Syndrome. Archives of Ophthalmology. 1969;82:322-9. doi: 10.1001/archopht.1969.00990020324005.

143. Miyazaki D, Takamura E, Uchio E, Ebihara N, Ohno S, Ohashi Y, et al. Japanese guidelines for allergic conjunctival diseases 2020. Allergology International. 2020;69:346-55. doi: 10.1016/j.alit.2020.03.005.

144. Bilkhu PS, Wolffsohn JS, Naroo SA, Robertson L, Kennedy R. Effectiveness of nonpharmacologic treatments for acute seasonal allergic conjunctivitis. Ophthalmology. 2014;121:72-8. doi: 10.1016/j.ophtha.2013.08.007.

145. Forister JF, Forister EF, Yeung KK, Ye P, Chung MY, Tsui A, Weissman BA. Prevalence of contact lens-related complications: UCLA contact lens study. Eye Contact Lens. 2009 Jul;35(4):176-80. doi: 10.1097/ICL.0b013e3181a7bda1.

146. Elhers WH, Donshik PC. Giant papillary conjunctivitis. Curr Opin Allergy Clin Immunol. 2008 Oct;8(5):445-9. doi: 10.1097/ACI.0b013e32830e6af0.

147. Leonardi A, Silva D, Perez Formigo D, Bozkurt B, Sharma V, Allegri P, et al. Management of ocular allergy. Allergy. 2019;74:1611-30. doi: 10.1111/all.13786.

148. Rubini N de PM, Wandalsen GF, Rizzo MC v., Aun M v., Chong Neto HJ, Solé D. Guia prático sobre controle ambiental para pacientes com rinite alérgica. Arq Asma Alerg Imunol. 2017;1. doi: 10.5935/2526-5393.20170004.

149. Bousquet J, Schünemann HJ, Togias A, Bachert C, Erhola M, Hellings PW, et al. Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence. J Allergy Clin Immunol. 2020;145:70-80.e3. doi: 10.1016/j.jaci.2019.06.049.

150. Spector SL, Raizman MB. Conjunctivitis medicamentosa. J Allergy Clin Immunol. 1994;94:134-6. doi: 10.1016/0091-6749(94)90081-7.

151. Papathanassiou M, Giannoulaki V, Tiligada E. Leukotriene antagonists attenuate late phase nitric oxide production during the hypersensitivity response in the conjunctiva. Inflammation Research. 2004;53. doi: 10.1007/s00011-004-1270-4.

152. Bielory L, Schoenberg D. Emerging Therapeutics for Ocular Surface Disease. Curr Allergy Asthma Rep. 2019 Feb 28;19(3):16. doi: 10.1007/s11882-019-0844-8.

153. Bielory L, Bielory BP, Wagner RS. Ocular Allergy. In: Leung DYM, Szefler SJ, Bonilla FA, Akdis CA, Sampson H, eds. Pediatric Allergy: Principles and Practice, vol. 1. 3ª ed. New York: Elsevier; 2015. p. 482-97.

154. Wan KH-N, Chen LJ, Rong SS, Pang CP, Young AL. Topical Cyclosporine in the Treatment of Allergic Conjunctivitis. Ophthalmology. 2013;120:2197-203. doi: 10.1016/j.ophtha.2013.03.044.

155. González-López JJ, López-Alcalde J, Morcillo Laiz R, Fernández Buenaga R, Rebolleda Fernández G. Topical cyclosporine for atopic keratoconjunctivitis. Cochrane Database Syst Rev. 2012. doi: 10.1002/14651858.CD009078.pub2.

156. Secchi AG, Tognon MS, Leonardi A. Topical Use of Cyclosporine in the Treatment of Vernal Keratoconjunctivitis. Am J Ophthalmol. 1990;110:641-5. doi: 10.1016/S0002-9394(14)77061-8.

157. Utine CA, Stern M, Akpek EK. Clinical Review: Topical Ophthalmic Use of Cyclosporin A. Ocul Immunol Inflamm. 2010;18:352-61. doi: 10.3109/09273948.2010.498657.

158. Pucci N, Novembre E, Cianferoni A, Lombardi E, Bernardini R, Caputo R, et al. Efficacy and safety of cyclosporine eyedrops in vernal keratoconjunctivitis. Ann Allergy Asthma Immunol. 2002;89:298-303. doi: 10.1016/S1081-1206(10)61958-8.

159. Pucci N, Caputo R, Mori F, de Libero C, di Grande L, Massai C, et al. Long-Term Safety and Efficacy of Topical Cyclosporine in 156 Children with Vernal Keratoconjunctivitis. Int J Immunopathol Pharmacol. 2010;23:865-71. doi: 10.1177/039463201002300322.

160. Leonardi A, Borghesan F, Faggian D, Secchi A, Plebani M. Eosinophil cationic protein in tears of normal subjects and patients affected by vernal keratoconjunctivitis. Allergy. 1995;50:610-3. doi: 10.1111/j.1398-9995.1995.tb01209.x.

161. Cetinkaya A, Akova YA, Dursun D, Pelit A. Topical cyclosporine in the management of shield ulcers. Cornea. 2004 Mar;23(2):194-200. doi: 10.1097/00003226-200403000-00014.

162. Daniell M. Randomised controlled trial of topical ciclosporin A in steroid dependent allergic conjunctivitis. Br J Ophthalmol. 2006;90:461-4. doi: 10.1136/bjo.2005.082461.

163. Ozcan AA, Ersoz TR, Dulger E. Management of severe allergic conjunctivitis with topical cyclosporin A 0.05% Eyedrops. Cornea. 2007;26:1035-8. doi: 10.1097/ICO.0b013e31812dfab3.

164. Lambiase A, Leonardi A, Sacchetti M, Deligianni V, Sposato S, Bonini S. Topical cyclosporine prevents seasonal recurrences of vernal keratoconjunctivitis in a randomized, double-masked, controlled 2-year study. J Allergy Clin Immunol. 2011;128:896-897.e9. doi: 10.1016/j.jaci.2011.07.004.

165. Ebihara N, Ohashi Y, Uchio E, Okamoto S, Kumagai N, Shoji J, et al. A large prospective observational study of novel cyclosporine 0.1% aqueous ophthalmic solution in the treatment of severe allergic conjunctivitis. J Ocul Pharmacol Ther. 2009 Aug;25(4):365-72. doi: 10.1089/jop.2008.0103.

166. Leonardi A, Doan S, Amrane M, Ismail D, Montero J, Németh J, et al. A Randomized, Controlled Trial of Cyclosporine A Cationic Emulsion in Pediatric Vernal Keratoconjunctivitis. Ophthalmology. 2019;126:671-81. doi: 10.1016/j.ophtha.2018.12.027.

167. Bremond-Gignac D, Doan S, Amrane M, Ismail D, Montero J, Németh J, et al. Twelve-month results of cyclosporine a cationic emulsion in a randomized study in patients with pediatric vernal keratoconjunctivitis. Am J Ophthalmol. 2020;212:116-26. doi: 10.1016/j.ajo.2019.11.020.

168. Rikkers SM, Holland GN, Drayton GE, Michel FK, Torres MF, Takahashi S. Topical tacrolimus treatment of atopic eyelid disease. Am J Ophthalmol. 2003;135:297-302. doi: 10.1016/S0002-9394(02)01982-7.

169. Vichyanond P, Tantimongkolsuk C, Dumrongkigchaiporn P, Jirapongsananuruk O, Visitsunthorn N, Kosrirukvongs P. Vernal keratoconjunctivitisResult of a novel therapy with 0.1% topical ophthalmic FK-506 ointment. J Allergy Clin Immunol. 2004;113:355-8. doi: 10.1016/j.jaci.2003.10.065.

170. Virtanen HM, Reitamo S, Kari M, Kari O. Effect of 0.03% tacrolimus ointment on conjunctival cytology in patients with severe atopic blepharoconjunctivitis: a retrospective study. Acta Ophthalmologica Scandinavica. 2006;84:693-5. doi: 10.1111/j.1600-0420.2006.00699.x.

171. Attas-Fox L, Barkana Y, Iskhakov V, Rayvich S, Gerber Y, Morad Y, et al. Topical Tacrolimus 0.03% Ointment for Intractable Allergic Conjunctivitis: An Open-Label Pilot Study. Current Eye Research. 2008;33:545-9. doi: 10.1080/02713680802149115.

172. Ohashi Y, Ebihara N, Fujishima H, Fukushima A, Kumagai N, Nakagawa Y, et al. A Randomized, Placebo-Controlled Clinical Trial of Tacrolimus Ophthalmic Suspension 0.1% in Severe Allergic Conjunctivitis. J Ocul Pharmacol Ther. 2010;26:165-74. doi: 10.1089/jop.2009.0087.

173. Zhai J, Gu J, Yuan J, Chen J. Tacrolimus in the Treatment of Ocular Diseases. BioDrugs. 2011;25:89-103. doi: 10.2165/11587010-000000000-00000.

174. Labcharoenwongs P, Jirapongsananuruk O, Visitsunthorn N, Kosrirukvongs P, Saengin P, Vichyanond P. A double-masked comparison of 0.1% tacrolimus ointment and 2% cyclosporine eye drops in the treatment of vernal keratoconjunctivitis in children. Asian Pac J Allergy Immunol. 2012;30:177-84.

175. Pucci N, Caputo R, di Grande L, de Libero C, Mori F, Barni S, et al. Tacrolimus vs. cyclosporine eyedrops in severe cyclosporine-resistant vernal keratoconjunctivitis: A randomized, comparative, double-blind, crossover study. Pediatr Allergy Immunol. 2015;26:256-61. doi: 10.1111/pai.12360.

176. Miyazaki D, Fukushima A, Ohashi Y, Ebihara N, Uchio E, Okamoto S, et al. Steroid-Sparing Effect of 0.1% tacrolimus eye drop for treatment of shield ulcer and corneal epitheliopathy in refractory allergic ocular diseases. Ophthalmology. 2017;124:287-94. doi: 10.1016/j.ophtha.2016.11.002.

177. Nivenius E, van der Ploeg I, Jung K, Chryssanthou E, van Hage M, Montan PG. Tacrolimus ointment vs steroid ointment for eyelid dermatitis in patients with atopic keratoconjunctivitis. Eye. 2007;21:968-75. doi: 10.1038/sj.eye.6702367.

178. Zribi H, Descamps V, Hoang-Xuan T, Crickx B, Doan S. Dramatic improvement of atopic keratoconjunctivitis after topical treatment with tacrolimus ointment restricted to the eyelids. Journal of the European Academy of Dermatology and Venereology. 2009;23:489-90. doi: 10.1111/j.1468-3083.2008.02933.x.

179. Al-Amri AM. Long-term Follow-up of Tacrolimus Ointment for Treatment of Atopic Keratoconjunctivitis. Am J Ophthalmol. 2014;157:280-6. doi: 10.1016/j.ajo.2013.10.006.

180. Yazu H, Fukagawa K, Shimizu E, Sato Y, Fujishima H. Long-term outcomes of 0.1% tacrolimus eye drops in eyes with severe allergic conjunctival diseases. Allergy Asthma Clin Immunol. 2021;17:11. doi: 10.1186/s13223-021-00513-w.

181. Hoang-Xuan T, Prisant O, Hannouche D, Robin H. Systemic Cyclosporine A in Severe Atopic Keratoconjunctivitis. Ophthalmology. 1997;104:1300-5. doi: 10.1016/S0161-6420(97)30144-4.

182. Agache I, Lau S, Akdis CA, Smolinska S, Bonini M, Cavkaytar O, et al. EAACI Guidelines on Allergen Immunotherapy: House dust mite-driven allergic asthma. Allergy. 2019 May;74(5):855-873. doi: 10.1111/all.13749.

183. Cox L, Nelson H, Lockey R, Calabria C, Chacko T, Finegold I, et al. Allergen immunotherapy: A practice parameter third update. J Allergy Clin Immunol. 2011;127:S1-55. doi: 10.1016/j.jaci.2010.09.034.

184. Akdis M, Akdis CA. Mechanisms of allergen-specific immunotherapy. J Allergy Clin Immunol. 2007;119:780-9. doi: 10.1016/j.jaci.2007.01.022.

185. Scadding GK, Durham SR, Mirakian R, Jones NS, Leech SC, Farooque S, et al. BSACI guidelines for the management of allergic and non-allergic rhinitis. Clin Exp Allergy. 2007;38:19-42. doi: 10.1111/j.1365-2222.2007.02888.x.

186. Calderon MA, Alves B, Jacobson M, Hurwitz B, Sheikh A, Durham S. Allergen injection immunotherapy for seasonal allergic rhinitis. Cochrane Database Syst Rev. 2007. doi: 10.1002/14651858.CD001936.pub2.

187. Passalacqua G, Canonica GW. Sublingual immunotherapy for allergic respiratory diseases: efficacy and safety. Immunol Allergy Clin North Am. 2011;31:265-77. doi: 10.1016/j.iac.2011.03.002.

188. Sayed KM, Kamel AG, Ali AH. One-year evaluation of clinical and immunological efficacy and safety of sublingual versus subcutaneous allergen immunotherapy in allergic conjunctivitis. Graefes Arch Clin Exp Ophthalmol. 2019;257:1989-96. doi: 10.1007/s00417-019-04389-w.

189. Lin SY, Erekosima N, Kim JM, Ramanathan M, Suarez-Cuervo C, Chelladurai Y, et al. Sublingual Immunotherapy for the Treatment of Allergic Rhinoconjunctivitis and Asthma. JAMA. 2013;309:1278. doi: 10.1001/jama.2013.2049.

190. Shamji MH, Layhadi JA, Sharif H, Penagos M, Durham SR. Immunological Responses and Biomarkers for Allergen-Specific Immunotherapy Against Inhaled Allergens. J Allergy Clin Immunol Pract. 2021;9:1769-78. doi: 10.1016/j.jaip.2021.03.029.

191. Cohon A, Arruda LK, Martins MA, Guilherme L, Kalil J. Evaluation of BCG administration as an adjuvant to specific immunotherapy in asthmatic children with mite allergy. J Allergy Clin Immunol. 2007;120:210-3. doi: 10.1016/j.jaci.2007.04.018.

192. Dupuis P, Prokopich CL, Hynes A, Kim H. A contemporary look at allergic conjunctivitis. Allergy Asthma Clin Immunol. 2020;16:5. doi: 10.1186/s13223-020-0403-9.

193. Williams PB, Sheppard Jr JD. Omalizumab: a future innovation for treatment of severe ocular allergy? Expert Opinion on Biological Therapy. 2005;5:1603-9. doi: 10.1517/14712598.5.12.1603.

194. Doan S, Amat F, Gabison E, Saf S, Cochereau I, Just J. Omalizumab in Severe Refractory Vernal Keratoconjunctivitis in Children: Case Series and Review of the Literature. Ophtalmol Ther. 2017;6:195-206. doi: 10.1007/s40123-016-0074-2.

195. Wollenberg A, Ariens L, Thurau S, van Luijk C, Seegräber M, de Bruin-Weller M. Conjunctivitis occurring in atopic dermatitis patients treated with dupilumab-clinical characteristics and treatment. J Allergy Clin Immunol Pract. 2018;6:1778-1780.e1. doi: 10.1016/j.jaip.2018.01.034.

196. Barnes AC, Blandford AD, Perry JD. Cicatricial ectropion in a patient treated with dupilumab. Am J Ophthalmol. Case Rep. 2017;7:120-2. doi: 10.1016/j.ajoc.2017.06.017.

197. Qiu J, Grine K. Complementary and alternative treatment for allergic conditions. Primary Care. 2016;43:519-26. doi: 10.1016/j.pop.2016.04.012.

198. Land MH, Wang J. Complementary and Alternative Medicine Use Among Allergy Practices: Results of a Nationwide Survey of Allergists. J Allergy Clin Immunol Pract. 2018;6:95-98.e3. doi: 10.1016/j.jaip.2017.01.017.

199. Sharma P, Singh G. A review of plant species used to treat conjunctivitis. Phytotherapy Research. 2002;16:1-22. doi: 10.1002/ptr.1076.

200. Thomet OAR, Simon H-U. Petasins in the treatment of allergic diseases: results of preclinical and clinical studies. Int Arch Allergy Immunol. 2002;129:108-12. doi: 10.1159/000065884.

201. Schapowal A. Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. BMJ. 2002;324:144-144. doi: 10.1136/bmj.324.7330.144.

202. Stoss M, Michels C, Peter E, Beutke R, Gorter RW. Prospective Cohort Trial of Euphrasia Single-Dose Eye Drops in Conjunctivitis. J Altern Complement Med. 2000;6:499-508. doi: 10.1089/acm.2000.6.499.

203. Rubio-Pina J, Vazquez-Flota F. Pharmaceutical applications of the benzylisoquinoline alkaloids from Argemone mexicana L. Curr Top Med Chem. 2013;13:2200-7. doi: 10.2174/15680266113139990152.

204. Shin T, Kim S, Suk K, Ha J, Kim I, Lee M, et al. Anti-allergic effects of on mast cell-mediated allergy model. Toxicol Appl Pharmacol. 2005;209:255-62. doi: 10.1016/j.taap.2005.04.011.

205. Bielory L, Tabliago NRA. Flavonoid and cannabinoid impact on the ocular surface. Curr Opin Allergy Clin Immunol. 2020;20:482-92. doi: 10.1097/ACI.0000000000000673.

206. Kapoor S, Bielory L. Allergic rhinoconjunctivitis: Complementary treatments for the 21st century. Curr Allergy Asthma Rep. 2009;9:121-7. doi: 10.1007/s11882-009-0018-1.

207. Dhiman K, Sharma G, Singh S. A clinical study to assess the efficacy of Triyushnadi Anjana in Kaphaja Abhishyanda with special reference to vernal keratoconjunctivitis. Ayu. 2010;31:466. doi: 10.4103/0974-8520.82044.

208. Xue CC, English R, Zhang JJ, da Costa C, Li CG. Effect of acupuncture in the treatment of seasonal allergic rhinitis: a randomized controlled clinical trial. Am J Chin Med. 2002;30:1-11. doi: 10.1142/S0192415X0200020X.

209. Xue CC, Li CG, Hügel HM, Story DF. Does acupuncture or Chinese herbal medicine have a role in the treatment of allergic rhinitis? Curr Opin Allergy Clin Immunol. 2006;6:175-9. doi: 10.1097/01.all.0000225156.29780.36.

210. Ng DK, Chow P, Ming S, Hong S, Lau S, Tse D, et al. A Double-blind, randomized, placebo-controlled trial of acupuncture for the treatment of childhood persistent allergic rhinitis. Pediatrics. 2004;114:1242-7. doi: 10.1542/peds.2004-0744.

211. Seidman MD, Gurgel RK, Lin SY, Schwartz SR, Baroody FM, Bonner JR, et al. Clinical Practice Guideline. Otolaryngology-Head and Neck Surgery. 2015;152:S1-43. doi: 10.1177/0194599814561600.

212. Bielory L, Heimall J. Review of complementary and alternative medicine in treatment of ocular allergies. Curr Opin Allergy Clin Immunol. 2003;3:395-9. doi: 10.1097/00130832-200310000-00013.

213. Bellavite P. Advances in homeopathy and immunology: a review of clinical research. Frontiers in Bioscience. 2011;S3:1363. doi: 10.2741/230.

214. Bellavite P, Ortolani R, Pontarollo F, Piasere V, Benato G, Conforti A. Immunology and Homeopathy. 4. Clinical Studies - Part 2. Evid Based Complement Alternat Med. 2006;3:397-409. doi: 10.1093/ecam/nel046.

215. Weiser M, Gegenheimer LH, Klein P. A randomized equivalence trial comparing the efficacy and safety of Luffa comp.-Heel nasal spray with cromolyn sodium spray in the treatment of seasonal allergic rhinitis. Complement Med Res. 1999;6:142-8. doi: 10.1159/000021239.

216. Goossens M, Laekeman G, Aertgeerts B, Buntinx F. Evaluation of the quality of life after individualized homeopathic treatment for seasonal allergic rhinitis. A prospective, open, non-comparative study. Homeopathy. 2009;98:11-6. doi: 10.1016/j.homp.2008.11.008.

217. Gründling C, Schimetta W, Frass M. Real-life effect of classical homeopathy in the treatment of allergies: A multicenter prospective observational study. Wiener Klinische Wochenschrift. 2012;124:11-7. doi: 10.1007/s00508-011-0104-y.

218. Ullman D, Frass M. A review of homeopathic research in the treatment of respiratory allergies. Altern Med Rev. 2010;15:48-58.

219. Rossi E, Picchi M, Bartoli P, Panozzo M, Cervino C, Nurra L. Homeopathic therapy in pediatric atopic diseases: short- and long-term results. Homeopathy 2016;105:217-24. doi: 10.1016/j.homp.2016.03.001.

220. Kim LS, Riedlinger JE, Baldwin CM, Hilli L, Khalsa SV, Messer SA, et al. Treatment of seasonal allergic rhinitis using homeopathic preparation of common allergens in the southwest region of the US: A randomized, controlled clinical trial. Annals of Pharmacotherapy. 2005;39:617-24. doi: 10.1345/aph.1E387.

221. Hara Y, Shiraishi A, Sakane Y, Takezawa Y, Kamao T, Ohashi Y, et al. Effect of mandarin orange yogurt on allergic conjunctivitis induced by conjunctival allergen challenge. Invest Ophthalmol Vis Sci. 2017;58:2922. doi: 10.1167/iovs.16-21206.

222. Dennis-Wall JC, Culpepper T, Nieves C, Rowe CC, Burns AM, Rusch CT, et al. Probiotics (Lactobacillus gasseri KS-13, Bifidobacterium bifidum G9-1, and Bifidobacterium longum MM-2) improve rhinoconjunctivitis-specific quality of life in individuals with seasonal allergies: a double-blind, placebo-controlled, randomized trial. Am J Clin Nutr. 2017;105:758-67. doi: 10.3945/ajcn.116.140012.

223. Burroni AG, Maio M. Ocular allergies: a psychodynamic approach. Curr Opin Allergy Clin Immunol. 2008;8:461-5. doi: 10.1097/ACI.0b013e32830f1dad.

224. Sánchez-Hernández MC, Montero J, Rondon C, Benitez del Castillo JM, Velázquez E, Herreras JM, et al. Consensus document on allergic conjunctivitis (DECA). J Investig Allergol Clin Immunol. 2015;25:94-106.

225. Juniper EF, Guyatt GH. Development and testing of a new measure of health status for clinical trials in rhinoconjunctivitis. Clin Exp Allergy. 1991 Jan;21(1):77-83. doi: 10.1111/j.1365-2222.1991.tb00807.x.

226. Schatz M, Meltzer EO, Nathan R, Derebery MJ, Mintz M, Stanford RH, et al. Psychometric validation of the Rhinitis Control Assessment Test: a brief patient-completed instrument for evaluating rhinitis symptom control. Ann Allergy Asthma Immunol. 2010;104:118-24. doi: 10.1016/j.anai.2009.11.063.

227. Bousquet PJ, Combescure C, Neukirch F, Klossek JM, Méchin H, Daures J-P, et al. Original article: Visual analog scales can assess the severity of rhinitis graded according to ARIA guidelines. Allergy. 2007;62:367-72. doi: 10.1111/j.1398-9995.2006.01276.x.

228. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*. Allergy. 2008;63:8-160. doi: 10.1111/j.1398-9995.2007.01620.x.

229. Bielory L. Ocular symptom reduction in patients with seasonal allergic rhinitis treated with the intranasal corticosteroid mometasone furoate. Ann Allergy Asthma Immunol. 2008;100:272-9. doi: 10.1016/S1081-1206(10)60453-X.

230. Sacchetti M, Baiardini I, Lambiase A, Aronni S, Fassio O, Gramiccioni C, et al. Development and Testing of the Quality of Life in Children with Vernal Keratoconjunctivitis Questionnaire. Am J Ophthalmol. 2007;144:557-563.e2. doi: 10.1016/j.ajo.2007.06.028.

231. Sánchez-Hernández MC, Navarro AM, Colás C, del Cuvillo A, Sastre J, Mullol J, et al. Validation of the DECA criteria for allergic conjunctivitis severity and control. Clin Transl Allergy. 2020;10:43. doi: 10.1186/s13601-020-00349-4.

232. Efron N, Morgan PB, Katsara SS. Validation of grading scales for contact lens complications. Ophthalmic Physiol Opt. 2001 Jan;21(1):17-29.

233. Rodrigues J, Kuruvilla ME, Vanijcharoenkarn K, Patel N, Hom MM, Wallace D v. The spectrum of allergic ocular diseases. Ann Allergy Asthma Immunol. 2021;126:240-54. doi: 10.1016/j.anai.2020.11.016.

234. Villegas BV, Benitez-Del-Castillo JM. Current Knowledge in Allergic Conjunctivitis. Turk J Ophthalmol. 2021 Feb 25;51(1):45-54. doi: 10.4274/tjo.galenos.2020.11456.

235. Aguilar-Angeles D, Lima-Gómez V, Rojo-Gutiérrez MI, Bermejo-Guevara MA, González-Ibarra M, López-Valladares KE. [Ocular findings most frequently found in patients with allergic rhinoconjunctivitis]. Cir Cir. 2007 Jan-Feb;75(1):13-7.

236. Ben-Eli H, Erdinest N, Solomon A. Pathogenesis and complications of chronic eye rubbing in ocular allergy. Curr Opin Allergy Clin Immunol. 2019;19:526-34. doi: 10.1097/ACI.0000000000000571.


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