Subcutaneous allergen-specific immunotherapy versus topical treatment in vernal keratoconjunctivitis.

PURPOSE: The study evaluated the treatment of cases with vernal keratoconjunctivitis by subcutaneous allergen-specific immunotherapy (SCIT) versus topical treatment according to clinical improvement and total serum immunoglobulin (Ig) E.

DESIGN

Prospective randomized study.

METHODS

The study included 64 patients with bilateral vernal keratoconjunctivitis. Cases were divided into 2 groups: group 1, 32 patients who were subjected to topical treatment; and group 2, 32 patients who were subjected to intradermal skin reactions to different allergens. Prepared subcutaneous injections of different allergens were administered. Follow-up was performed to detect criteria of improvement according to clinical data and total serum IgE.

RESULTS

The study revealed that the treatment by SCIT was more effective in improving the clinical symptoms and reducing the serum IgE than topical treatment because there was a greater reduction in symptoms in group 1 of immunotherapy (72%) than in group 2 of medical treatment (59%) (P < 0.05). Also, there was a significant reduction in total serum IgE (P < 0.05) in group 1 (62%) compared to group 2 (42%). However, the intradermal test for each group of patients showed that 62% of the patients were sensitive to pollens, 19% to house dust, and 19% to more than one allergen.

CONCLUSIONS

Treatment of vernal keratoconjunctivitis by SCIT was more effective than topical treatment in improving the clinical symptoms and reducing the total serum IgE.