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Component-resolved diagnosis technique effectively identifies vernal conjunctivitis

The use of component-resolved diagnosis may identify vernal conjunctivitis more accurately than the prick test and immunoglobulin E determination, according to study results.

The origin of vernal conjunctivitis cannot be sufficiently clarified using conventional diagnostic tests, according to study background.

Alicia Armentia, MD, PhD, of the allergy unit at Rio Hortega University Hospital in Valladolid, Spain, and colleagues conducted a study to evaluate IgE-mediated hypersensitivity by component-resolved diagnosis in serum and tears from patients with vernal conjunctivitis. They also assessed use of specific immunotherapy treatment approaches for patients with identified triggering allergens.

Armentia and colleagues evaluated 125 patients. Researchers divided participants into three groups: those with vernal conjunctivitis (n = 25), those who were allergic to grass pollen and had seasonal allergic conjunctivitis (n = 50) and healthy blood donors (n = 50).

The researchers administered specific conventional immunotherapy for 1 year to patients in whom triggering allergens were detected.

Component-resolved diagnosis demonstrated a similar specificity to other diagnostic tests; however, it demonstrated higher sensitivity (48%) than the prick test (8%) or IgE determination (16%).

Pollen allergen Lol p 1 from Lolium perenne, a common grass pollen allergen in the researchers’ local environment, served as a triggering allergen for 11 (44%) of the 25 patients with vernal conjunctivitis. The n Cyn d 1 allergen was a triggering allergen in eight (32%) patients; group 4 and group 6 grass allergens were triggering allergens for six (24%) patients; and group 5 grass allergens were triggering allergens for five (20%) patients.

One patient had positive results for the prick test and IgE test.

The researchers recommended allergen-specific immunotherapy for 1 year in 13 patients with vernal conjunctivitis and 37 patients with allergic conjunctivitis.

“All the patients with allergic conjunctivitis or vernal conjunctivitis improved after immunotherapy based on a validated score, including clinical, therapeutic and quality-of-life data,” Armentia and colleagues wrote. “Inflammation signs, cobblestoning of the eyelids and Hanta dots improved or disappeared, as [did] symptoms and needed medication.”

The results show component-resolved diagnosis techniques are highly specific and allow for diagnosis of more patients than the prick test and IgE determination, the researchers concluded.

“Serum testing with component-resolved diagnosis can be a useful tool to guide specific immunotherapy if patients cannot avoid the antigen,” Armentia and colleagues wrote. “The study indicates that vernal conjunctivitis can be treated with specific allergen immunotherapy, which is an important step in the treatment of this difficult condition. Component-resolved diagnosis-led immunotherapy in patients with vernal conjunctivitis and allergic conjunctivitis resulted in objective and subjective improvements without the need for symptomatic treatment.”– by Jeff Craven

Disclosure: The researchers report no relevant financial disclosures.