children with severe vernal keratoconjunctivitis

Background: We describe clinical characteristics and risk factors for corticosteroid response in children with severe vernal keratoconjunctivitis (VKC). Design: Retrospective, noncontrolled, comparative case series. Participants: Patients from three tertiary centers in Singapore. Methods: We reviewed patients with severe VKC (clinical grade. 2) who were on topical steroid therapy, with a minimum follow-up period of 1 year post-presentation. Logistic regression was used to determine risk factors for corticosteroid response. Main outcome measure: Corticosteroid response was defined as intraocular pressure (IOP).21 mmHg (three consecutive readings), or a rise of more than 16 mmHg from baseline, after commencement of steroid therapy in the absence of other possible causes of raised IOP. Results: Forty-one of 145 (28.3%) patients developed a corticosteroid response, of which eight (5.5%) progressed to glaucoma. The overall mean age of onset of VKC was 9.9 ± 4.4 years. Longer duration of corticosteroid use (OR, 5.06; 95 % CI: 1.04–25.56; P = 0.45) and topical dexamethasone 0.01 % (OR, 2.25; 95 % CI: 1.99–5.08; P = 0.40) were associated with corticos-teroid response. Mixed type of VKC (OR, 9.76; 95 % CI: 3.55–26.77; P, 0.001), the presenc