The benefit of scratch patch testing to demonstrate ocular contact allergy to brimonidine tartrate.

INTRODUCTION: Ocular allergies to brimonidine are frequent in patients treated for glaucoma. There is variability in reporting due to the lack of diagnostic criteria and the absence of cutaneous testing. Many false-negative patch tests (PT) have been described. Alternative methods, such as strip and scratch PT, have been used without a standardized method. OBJECTIVES: The primary objective is to identify the best method of cutaneous testing and brimonidine concentration for patch testing. The secondary objective is to identify clinical signs and symptoms suggestive of ocular allergy. PATIENTS AND METHODS: A retrospective review of patient files suspected of brimonidine ocular allergy was performed. Patch testing method, brimonidine concentration and clinical symptoms were reviewed. RESULTS: Of the 36 patients identified, half tested positive for brimonidine for at least one of the testing methods. The scratch PT demonstrated 17 positive reactions (94% detection rate). Three patients reacted with strip PT. No positive results were found with standard PT. The 5% brimonidine concentration demonstrated the highest sensitivity. The absence of eyelid pruritus was associated with negative testing. CONCLUSION: In the investigation of ocular allergy to brimonidine, scratch PT proved to be an essential tool. Brimonidine 5% pet. appeared as the most sensitive concentration for scratch PT.

Comparison of outcome measures in allergic rhinitis in children, adolescents and adults.

BACKGROUND: Grass pollen-induced allergic rhinoconjunctivitis (AR) is very common worldwide. However, its symptoms may vary with the patient's age. The present study compared symptom profiles and quality of life (QoL) in children, adolescents and adults with grass pollen-induced AR. METHODS: This was a four-week, multicentre, observational study of children (aged 6-11), adolescents (12-17) and adults (18-65) consulting specialist physicians in France. The management of AR was at the physicians' discretion. Participants regularly rated their symptoms (the rhinoconjunctivitis total symptom score (RTSS) and a visual analogue scale (VAS)) and QoL (the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). RESULTS: A total of 806 patients (253 children, 250 adolescents and 303 adults, of whom 83.5% suffered from moderate-to-severe, persistent AR) provided data for at least the first 2 weeks of the study. Ocular pruritus (the most bothersome symptom in children (35%), adolescents (22%) and adults (16%)) was associated with poor QoL in all groups, whereas nasal obstruction and pruritus were associated with poor QoL in adolescents and children. Over 4 weeks, the weekly mean RTSS and VAS scores fell by around half. This change was associated with an improvement in the RQLQ scores. In all age groups, the VAS score was well correlated with the weekly mean RTSS score (Pearson's r: 0.79-0.88) and moderately correlated with the weekly mean RQLQ score (Pearson's r: 0.64-0.80). CONCLUSIONS: In moderate-to-severe grass pollen-induced AR, symptom perception differs in children vs. older patients. However, the assessments of treatment outcomes (using the RTSS, VAS and RQLQ) were similar in all age groups.

Research progress on mechanism and signal pathway of ocular pruritus / 国际眼科杂志(Guoji Yanke Zazhi)

@#Ocular pruritus is one of the common symptoms of ocular surface diseases. People know little about the mechanism of ocular pruritus. In clinical practice, eye drops can only be used to relieve eye discomfort. Eye itch often makes patients feel extremely painful and uncomfortable. The itch is afferent from primary neurons, mainly small-diameter unmyelinated afferent neuron fibers, whose cell bodies are located in the dorsal root ganglia or trigeminal ganglia. These neurons transmit the itch from the skin to the central nervous system. In the spinal cord, these afferent nerves synapse with secondary neurons in the dorsal horn and send signals to the brain. Pruritus sensory neurons are generally considered to be a subgroup of pain neurons. Intensity coding theory suggests that at low emissivity, neuronal activity can cause the sensation of itching. With the advancement of molecular biology and neuroscience technology, it was discovered that one of the main functions of Mrgpr(mas-related G protein-coupled receptor)protein is pruritus, and most of Mrgprs(all MrgprA, MrgprB and MrgprC subfamily members, and MrgprD)are almost exclusively expressed in specific dorsal root and trigeminal ganglion neurons. This review will introduce the mechanism and signal pathways of ocular pruritus, as well as the role of Mrgpr protein in ocular pruritus, and provide help for the treatment of ocular pruritus.