Subcutaneous Allergen-specific Immunotherapy Versus Topical Treatment in Vernal Keratoconjunctivitis

Purpose: The study evaluated the treatment of cases with vernal keratoconjunctivitis by subcutaneous allergen-specific immunotherapy (SCIT) versus topical treatment according to clinical improvement and total serum immunoglobulin (Ig) E. Design: Prospective randomized study. Methods: The study included 64 patients with bilateral vernal keratoconjunctivitis. Cases were divided into 2 groups: group 1, 32 patients who were subjected to topical treatment; and group 2, 32 patients who were subjected to intradermal skin reactions to different allergens. Prepared subcutaneous injections of different allergens were administered. Follow-up was performed to detect criteria of improvement according to clinical data and total serum IgE. Results: The study revealed that the treatment by SCIT was more effective in improving the clinical symptoms and reducing the serum IgE than topical treatment because there was a greater reduction in symptoms in group 1 of immunotherapy (72\%) than in group 2 of medical treatment (59\%) (P<0.05). Also, there was a significant reduction in total serum IgE (P<0.05) in group 1 (62\%) compared to group 2 (42\%). However, the intradermal test for each group of patients showed that 62\% of the patients were sensitive to pollens, 19\% to house dust, and 19\% to more than one allergen. Conclusions: Treatment of vernal keratoconjunctivitis by SCIT was more effective than topical treatment in improving the clinical symptoms and reducing the total serum IgE.