Postgraduate, Department of Internal Medicine, Federal University of Paraná, Curitiba, Brazil.
Ann Allergy Asthma Immunol. 2011 Jul;107(1):29-34. doi: 10.1016/j.anai.2011.03.002. Epub 2011 Apr 14.
Ocular symptoms can be triggered by nonspecific environmental factors, characterizing conjunctival hyperreactivity (CHR).
To examine CHR in subjects with ocular symptoms by means of a hyperosmolar conjunctival provocation test (HCPT).
Sixty-three subjects with ocular complaints (itching, redness, or tearing) were tested for allergy to a common panel of inhalant allergens (Alk Abelló-FDA Allergenic, Brazil). They were considered allergic if tests were positive to at least 1 allergen. HCPT with serial diluted glucose concentrations was positive if it produced conjunctival hyperemia up to a 50% solution. Digital images were analyzed by 2 observers who marked redness in the challenged eyes in red (GIMP 2.6.5 software). The number of red dots of the affected eye was compared with the number of blue dots of the control eye.
HCPT was positive in 6 of 7 grass pollen-sensitive subjects, in 17 of 20 dust mite-sensitive subjects, and in 10 of 11 subjects who were sensitive to both allergens. HCPT was positive in 33 of 38 allergic subjects (87%) and in 4 of 25 (16%) non-allergic subjects; sensitivity was 87%, and specificity was 84%. Significant correlation (r = 0.96 Pearson; P < .0001) was seen between the number of red dots in 23 digitalized images marked by observers.
HCPT indentified CHR in allergic as well as in non-allergic subjects. Allergic subjects exhibited more CHR than did non-allergic subjects. Conjunctival hyperreactivity was present in allergic subjects even when they were asymptomatic. Digital images may be useful for objective evaluation of ocular hyperemia in HCPT.
眼部症状可由非特异性环境因素引发，表现为结膜高反应性（CHR）。
通过高渗结膜激发试验（HCPT）检查有眼部症状的患者的 CHR。
对 63 例有眼部不适（瘙痒、发红或流泪）症状的患者进行常见吸入性过敏原检测（Alk Abelló-FDA Allergenic，巴西）。如果对至少 1 种过敏原的检测呈阳性，则认为患者过敏。如果结膜充血达到 50%葡萄糖溶液浓度，则 HCPT 为阳性。由 2 名观察者使用 GIMP 2.6.5 软件对受刺激眼睛的红色区域进行数字化图像分析，并标记红色（GIMP 2.6.5 软件）。受影响眼睛的红色斑点数量与对照眼睛的蓝色斑点数量进行比较。
7 例草花粉敏感患者中，6 例 HCPT 阳性；20 例尘螨敏感患者中，17 例 HCPT 阳性；11 例同时对两种过敏原敏感的患者中，10 例 HCPT 阳性。38 例过敏患者中有 33 例（87%）HCPT 阳性，25 例非过敏患者中有 4 例（16%）HCPT 阳性；敏感性为 87%，特异性为 84%。23 张由观察者标记的数字化图像的红色斑点数量之间存在显著相关性（Pearson 相关系数 r = 0.96；P <.0001）。
HCPT 可识别过敏和非过敏患者的 CHR。与非过敏患者相比，过敏患者的 CHR 更为明显。即使在无症状的情况下，过敏患者也存在结膜高反应性。数字化图像可用于 HCPT 中眼部充血的客观评估。
