Severity and duration of allergic conjunctivitis: are they associated with severity and duration of allergic rhinitis and asthma?

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1Allergology UGS, Hospital Universitario Virgen Macarena, Sevilla, Spain
2Allergy Unit, Department of Internal Medicine, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
3Allergy Service, Hospital Universitario de Salamanca, Salamanca, Spain
4Department of Allergology, Hospital El Bierzo, Ponferrada, León, Spain
5Department of Allergology, Hospital Clínico Universitario-Instituto de Investigación Sanitaria de Aragón, Universidad de Zaragoza, Zaragoza, Spain
6Allergy Unit, Hospital Universitario Regional de Málaga-ARADyAL, UMA, Málaga, Spain
7Asthma and Rhinitis Unit, Department of Otorhinolaryngology, Hospital de Jerez, Jerez, Spain
8 Department of Allergology, Hospital de la Princesa, Instituto de Investigación Sanitaria (IP), Madrid, Spain
9Allergy Unit, Faculty of Medicine, Hospital de Líria, Universidad Católica de Valencia, San Vicente Mártir, Valencia, Spain
10Department of Allergology, Hospital La Paz, Madrid, Spain
11Allergy Service, Hospital Universitario de Canarias, Tenerife, Spain
12Department of Allergology, Hospital Clínico San Carlos, Madrid, Spain
13Allergy Service, Allergy Unit, Consorci Sanitari de Terrassa, Clinica Diagonal, Barcelona, Spain
14Allergy Unit, Hospital Quirón, Barcelona, Spain
15Allergy Unit, CCEE Araba, Vitoria, Spain
16Biostatistics Unit, Department of Preventive Medicine and Public Health, Universidad de Sevilla, Spain
17Department of Pneumology and Allergy, Hospital Clínic i Universitari, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERES, Barcelona, Spain


Published: 26 July 2021
Accepted: 26 July 2021
Received: 14 May 2021


Objective. The association of allergic conjunctivitis (AC) with rhinitis and/or asthma is poorly understood. The objective of this study was to apply the Consensus Document for Allergic Conjunctivitis (DECA) criteria for the classification of AC to a population of patients with AC to assess the association between the severity and duration of AC and rhinitis and/or asthma. Methods. Patients with ocular symptoms of AC who participated in the ‘Alergológica 2015’ study were included. The demographics, classification according to the DECA criteria, etiology, and comorbidities were evaluated by age groups (≤ 14 and > 14 years). Results. A total of 2,914 patients (age range, 1-90 years) were included in the “Alergológica 2015” study. Of these, 965 patients (33.1%) were diagnosed with AC (77.5% > 14 years). AC was classified as severe, moderate, or mild in 1.8%, 46.4%, and 51.8%, respectively; and as intermittent or persistent in 51.6% and 48.4% of the patients. AC alone occurred in 4% of patients. AC was mainly associated with rhinitis (88.4%), asthma (38.2%), food allergy (8.3%) and atopic dermatitis (3.5%). In allergic respiratory disease rhinitis preceded AC and asthma developed later. The severity and duration of AC was significantly associated with severity and duration of rhinitis (p < 0.001 for both age groups) and asthma (p < 0.001 only in adults). Conclusions. The application of the new DECA classification for AC reveals a direct relationship between AC, rhinitis and asthma respect to severity and duration. These relationships suggest that AC should be considered an integral part of the ‘one airway, one disease’ hypothesis. 

Allergic conjunctivitis; allergic comorbidity; allergic respiratory disease; epidemiology; one airway.

Table of Content: Vol. 54 (No. 6) 2022 November

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