Long-term improvement of vernal keratoconjunctivitis following viral conjunctivitis

Eur J Ophthalmol. 2006 May-Jun;16(3):470-3.

Allergy and infections: Long-term improvement of vernal keratoconjunctivitis following viral conjunctivitis.

Sgrulletta R, Bonini S, Lambiase A, Bonini S. Interdisciplinary Center for Biomedical Research (CIR), Laboratory of Ophthalmology, University of Roma 'Campus Bio-Medico' and G.B. Bietti Eye Foundation, IRCCS, Roma - Italy.

PURPOSE. Vernal keratoconjunctivitis (VKC) is a severe, chronic allergic inflammatory disease of the ocular surface poorly responsive to antiallergic treatments and possibly leading to permanent visual impairment. VKC, because of mast cell, eosinophil, and Th2-type inflammation, polyclonal IgE activation, and tissue remodeling, is considered to be a typical Th2- driven disease. Viral infection stimulates a Th1 type immune response, potentially attenuating allergen-induced inflammation. The purpose of this report is to describe the effect of viral keratoconjunctivitis in a patient with VKC. METHODS. The authors report on a patient with a severe form of VKC, poorly responsive to antiallergic treatments, who developed a viral keratoconjunctivitis. Signs, symptoms, and cytologic findings were recorded during the 5-year follow-up period. RESULTS. The authors observed a prompt and permanent improvement of signs and symptoms of the allergic condition after the viral infection. Conjunctival scraping confirms that the inhibition of the eosinophilic inflammation lasts at least for 5 years. CONCLUSIONS. In this case, the viral infection seemed to induce a clinical recovery of allergic disease, suggesting that an immune deviation induced by Th1-polarizing agents may revert an ongoing Th2 inflammation.

PMID: 16761253 [PubMed - in process]