Schröder K, Finis D, Meller S, Buhren B A, Wagenmann M, Geerling G
Augenklinik, Universitätsklinikum Düsseldorf, Düsseldorf.
Hautklinik, Universitätsklinikum Düsseldorf, Düsseldorf.
Laryngorhinootologie. 2017 Feb;96(2):89-97. doi: 10.1055/s-0043-101391. Epub 2017 Mar 14.
Seasonsal allergic conjunctivitis (SAC) and perennial allergic conjunctivitis (PAC) as well as intermittent and persistent allergic rhinitis are widespread diseases. Because a combined occurrence of ocular and nasal symptoms is very common the summarising term allergic rhinoconjunctivitis is frequently used. SAC and PAC representing the two acute forms of allergic conjunctivitis account for more than 90% of all cases of allergic conjunctivitis. Compared to the chronic forms of allergic conjunctivitis their course of disease is milder. Nevertheless because of their high prevalence and the proven influence on patients' quality of life they possess clinical and socioeconomic relevance. Allergic rhinoconjunctivitis is caused by a type 1 IgE-mediated hypersensitivitity reaction that is provoked by aeroallergens in the majority of cases. The pathognomonic sign is itching. Besides, typical ocular findings are chemosis, conjunctival injection,watery secretion and lid swelling. Otorhinolaryngologists' findings include rhinorrhea, postnasal drip and sneezing. Problems in breathing through the nose resulting from nasal obstruction can cause impaired nighttime sleep and daytime somnolence. In addition to a reduction of allergen exposure by modification of environment and life style factors, in mild forms of SAC and PAC artificial tears are recommended. Topical antihistamines can generate rapid relief from acute symptoms and itching. Topical mast cell stabilisers however provide long-term effects. Dual action drugs that combine antihistamines and mast cell stabilisers show increased patient compliance due to reduced application frequency. Use of topical steroids should be cautious and only temporary. For prolonged treatment periods unpreserved anti-allergic eye-drops should be preferred. Combined topical antihistamines and new-generation topical nasal steroids often used by otorhinolaryngologists demonstrate a good safety profile without systemic side effects. In summary, allergic rhinoconjunctivitis represents a common disease pattern that can be treated effectively. Once it is diagnosed correctly targeted treatment results in improved patients' quality of life quickly.
季节性过敏性结膜炎（SAC）、常年性过敏性结膜炎（PAC）以及间歇性和持续性过敏性鼻炎都是常见疾病。由于眼部和鼻部症状同时出现的情况非常普遍，因此经常使用“过敏性鼻结膜炎”这一概括性术语。SAC和PAC是过敏性结膜炎的两种急性形式，占所有过敏性结膜炎病例的90%以上。与慢性过敏性结膜炎相比，它们的病程较轻。然而，由于其高发病率以及对患者生活质量的显著影响，它们具有临床和社会经济意义。过敏性鼻结膜炎是由1型IgE介导的超敏反应引起的，在大多数情况下由气传变应原诱发。其特征性症状是瘙痒。此外，典型的眼部表现包括结膜水肿、结膜充血、水样分泌物和眼睑肿胀。耳鼻喉科医生观察到的症状包括鼻漏、鼻后滴漏和打喷嚏。鼻塞导致的经鼻呼吸问题可引起夜间睡眠障碍和白天嗜睡。除了通过改变环境和生活方式因素减少变应原暴露外，对于轻度SAC和PAC，建议使用人工泪液。局部抗组胺药可迅速缓解急性症状和瘙痒。然而，局部肥大细胞稳定剂具有长期疗效。将抗组胺药和肥大细胞稳定剂结合的双重作用药物由于用药频率降低而显示出更高的患者依从性。局部类固醇的使用应谨慎，且只能短期使用。对于长期治疗，应首选无防腐剂的抗过敏滴眼液。耳鼻喉科医生常用的局部抗组胺药和新一代局部鼻用类固醇联合使用显示出良好的安全性，无全身副作用。总之，过敏性鼻结膜炎是一种常见的疾病模式，可以得到有效治疗。一旦正确诊断，针对性治疗可迅速改善患者的生活质量。
