Bielory Leonard
Clinical Research and Development, Division of Allergy, Immunology and Rheumatology, New Jersey Medical School, Newark, New Jersey 07103, USA.
Curr Opin Allergy Clin Immunol. 2006 Oct;6(5):355-60. doi: 10.1097/01.all.0000244796.48981.24.
To increase the awareness of nonimmunoglobulin E-mediated conjunctival disorders similar to those recognized to affect other organs that are targets in immunoglobulin E-mediated disorders. Such conditions may include 'vasomotor' instability, that is vasomotor conjunctivitis, which leads to a more common perennial chronic conjunctivitis. These conditions are not commonly included in the differential diagnosis of allergic conjunctivitis.
Although there have not been specific recent findings regarding the eye, it appears that evidence for such disorders in the rhinitis literature suggests that they can be involved in more than 25% of chronic conjunctivitis cases. The extrapolation of such conditions to the conjunctival surface clearly reflects these syndromes which have clearly been underappreciated and underdiagnosed.
A significant amount of work remains to be performed to understand perennial chronic conjunctivitis (vasomotor conjunctivitis or nonallergic noninfectious conjunctivitis) as well as other forms of chronic conjunctivitis that can mimic or exist in a comorbid state with ocular allergy. These disorders need to be better defined, categorized and classified to determine the best treatment modalities. Management guidelines and parameters of chronic noninfectious conjunctivitis need to be set on a national and international basis that will advance clinically applicable research results, pharmaceutical development and relief for patients.
提高对非免疫球蛋白E介导的结膜疾病的认识，这类疾病类似于那些已知会影响免疫球蛋白E介导疾病所针对的其他器官的疾病。此类情况可能包括“血管运动性”不稳定，即血管运动性结膜炎，它会导致一种更常见的常年性慢性结膜炎。这些情况在过敏性结膜炎的鉴别诊断中通常未被纳入。
尽管近期没有关于眼部的具体发现，但鼻炎文献中有关此类疾病的证据表明，它们可能涉及超过25%的慢性结膜炎病例。将这些情况外推至结膜表面清楚地反映出这些综合征显然未得到充分认识和诊断不足。
要了解常年性慢性结膜炎（血管运动性结膜炎或非过敏性非感染性结膜炎）以及其他可能与眼部过敏相似或并存的慢性结膜炎形式，仍有大量工作要做。需要更好地对这些疾病进行定义、分类，以确定最佳治疗方式。需要在国家和国际层面制定慢性非感染性结膜炎的管理指南和参数，这将推动临床应用研究成果、药物研发以及为患者带来缓解。
