Correlation between conjunctival provocation test (CPT) and systemic allergometric tests in allergic conjunctivitis

Regional Centre for the Diagnosis and the Treatment of Inflammatory Eye Diseases, University of Padova, Italy.
Eye (Impact Factor: 2.08). 02/1990; 4 ( Pt 5)(5):760-4. DOI: 10.1038/eye.1990.109
Source: PubMed


In order to assess the potential usefulness of CPT as a diagnostic tool for ocular allergy, the correlation between skin/RAST tests and CPT was determined in 144 patients affected by allergic 'hay fever' type conjunctivitis. The results showed that an agreement between skin/RAST tests and CPT occurred in 71% of the cases (130/183). Of the 29% uncorrelated cases, 23% (43/183) were positive for at least one specific antigen by skin/RAST tests but not by CPT, while 6% (10/183) were positive for at least one specific antigen by CPT, but not by skin/RAST tests. CPT dramatically increased the histamine levels in tears (p less than 0.001). These findings show that (1) systemic tests can be misleading in that they may suggest a specific sensitisation which, in fact, does not involve the conjunctiva (systemic test positive/CPT negative); (2) CPT can identify local conjunctival sensitisation in the absence of a systemic sensitisation (systemic test negative/CPT positive); (3) CPT can demonstrate that allergic 'hay fever' type conjunctivitis may be related to allergens different from those responsible for a systemic sensitisation.

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Available from: Andrea Leonardi, Mar 11, 2014
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    • "In assessing the potential usefulness of CPTs as a diagnostic tool, it was found that CPTs directly correlated to the radioallergosorbent test (RAST) in 71% (n ¼ 130/183) of allergic patients. Of the 29% of uncorrelated cases, 23% (43/183) were positive by RAST but not by CPT, whereas 6% (10/183) were positive by CPT but not by RAST [30]. This finding suggests that there may be local sensitization of the target organ without evidence for systemic sensitization to the same antigen that clinically may reflect allergens causing ocular symptoms without any evidence of pulmonary or nasal allergic symptoms. "
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    ABSTRACT: Allergic conjunctivitis, unlike many ocular conditions, is rarely associated with permanent visual impairment. It is, however, a common and extremely uncomfortable problem for those who are affected. Because patients with allergic conjunctivitis may be seen by the allergist and the ophthalmologist, it is important for both to recognize the hallmarks of allergic conjunctivitis and to understand the different therapeutic alternatives for the management of this condition.
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  • No preview · Article · Nov 1992 · Clinical & Experimental Allergy
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    ABSTRACT: The potential for ocular allergic patients to have a site-specific antigen sensitisation was investigated using various diagnostic tests of allergen sensitivity in subjects with allergic conjunctivitis (AC: n = 135), vernal keratoconjunctivitis (VK: n = 20), rhinoconjunctivitis (n = 20) or rhinitis (N = 10). In the AC and VK patients, skin tests and conjunctival provocation tests (CPT) were performed, and the levels of specific IgE in serum and in tears were identified. A subgroup of 36 patients was also challenged with a nasal-specific provocation test (NPT). Results showed a poor correlation between skin test results and tear-specific IgE, and also between serum-specific IgE and tear-specific IgE in both AC and VK patients (K < 0.3). CPT and tear IgE were significantly correlated (K = 0.5) in the ocular allergic population. In patients with rhinoconjunctivitis or rhinitis, and in 10 normal subjects, results of CPT and NPT were in 100% agreement. Conversely, in patients with only conjunctivitis, little correlation was found between the results of CPT and NPT (K = 0.3). Tear-specific IgE was the only positive diagnostic sign of antigen sensitivity in 35% of VK patients and 30% of AC patients. These results suggest that the conjunctiva can be a uniquely sensitised target organ in allergic patients.
    Full-text · Article · May 1993 · Eye
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