VERNAL KERATOCONJUNCTIVITIS : EPIDEMIOLOGICAL, CLINICAL AND THERAPEUTIC PROFILE

The aim of our work is to establish the epidemiological, clinical as well as therapeutic profile in our context, and to compare our results with those of the literature.

Vernal keratoconjunctivitis (VKC) is an allergic disease of the ocular surface, mainly affecting young children. It is responsible for outbreaks of major conjunctivocorneal inflammation. Epidemio-clinical presentations vary from one geographical region to another.  

Retrospective descriptive study from January 2019 to January 2022 at the ophthalmology department CHU Ibn Rochd de Casablanca  that included patients with vernal keratoconjunctivitis without distinction of age. The diagnosis of KCV was based on an interrogation and a routine ophthalmological examination.  Epidemiological, clinical and therapeutic information was collected from consultation files and registers. Were excluded: patients with incomplete consultation records or insufficient information, or not found.

34 patients were identified. Mean age: 9 years, with extremes ranging from 2 to 20 years. 77.1% of patients were aged ≤ 12 years at diagnosis. Male predominance: 68.6%, with a sex ratio (M/F) of 2.1 . Peak frequency between May and July. 40% of cases had other associated allergic conditions. Complaints were dominated by pruritus (68.5%), redness (57.1%) and photophobia (48.6%). Papillae (100%), hyperhemia and mucous discharges dominated clinical signs, 83% and 51.4% respectively.

     The tarsal form was observed in 51.4% of children, followed by the mixed form in 28.5%. Severity was classified as mild to moderate in 91.5% (grade I and II in the classification of M. Sachetti et al). Three cases of corneal involvement: superficial punctate keratitis in two patients and a vernal plaque in the third. 

Nonpharmacologic measures, such as artificial tears or saline solution were prescribed to all patients. Dual-acting antihistamine–mast cell stabilizer agents were prescribed to 60% of patients. Corticosteroids were used in 31.4% of patients, of whom 22.9% were moderate cases. Molecules with low ocular absorption, such as fluorometholone, were more prescribed. One case of cortico-dependence was treated with local cyclosporine 2%. One case of vernal plaque required surgical debridement.

Vernal keratoconjunctivitis is a well-defined pathology that is usually easy to diagnose. The problem of its management is posed by its prolonged course and the constraints imposed by its treatment.