Frequency, intensity and impact of ocular symptoms in allergic rhinitis: FIRE study

Background. - The purpose of the study was to describe the frequency, intensity and impact of ocular symptoms in allergic rhinitis and identify the existence of a specific profile of patients with major ocular symptoms. Methods. - Cross-sectional observational study conducted in daily practice. Ocular involvement was assessed by 0-19 Total Score Subjective Syndrome (TSSS) and the Total Ocular Sign Score (TOSS) and quality of life by Mini-RQLQ. The identification of the profiles was performed by logistic regression analysis and cluster analysis. Results. - In total, 2719 patients aged 38.0 14.0 among whom 53.1% of women were analyzed. A total of 22.4% had mild intermittent rhinitis, 15.0% moderate to severe intermittent rhinitis, 13.3% mild persistent rhinitis and 49.2% moderate to severe persistent rhinitis. Their PAREO score was 1.9 +/- 0.6. Their TOSS score was 41.5 +/- 22.8 in 100, their TSSS score was 6.4 +/- 3.3 in 15 and 25.9% of them had a value > 8 corresponding to a major symptomatology. Cluster analysis identified among all patients the existence of a homogeneous group of patients characterized by a more significant ocular involvement (TSSS: 8.5 +/- vs 4.6 +/- 2.7, P < 0.0001; TOSS: 60.3 +/- 16.0 vs 25.8 +/- 14.1, P < 0.0001) whose rhinitis was more frequently persistent with a moderate to severe intensity (61.4% vs 39.0%, P < 0.0001), and with a greater impairment of the quality of life (3.5 +/- 1.0 vs 2.5 +/- 1.0, P < 0.0001). The logistic regression analysis confirmed these data showing also that pollen but also fungal spore allergens are more frequently identified. In these patients the practitioners more frequently associated intranasal corticosteroids (73.9% vs 67.6%, P < 0.001) and cromones (76.0% vs 52.6%, P < 0.0001) with oral H1 antihistamines. Conclusion. - The association of rhinitis and ocular symptoms could be a frequent and specific entity requiring a specific treatment combining oral H1 antihistamines and cromones. 2016 Elsevier Masson SAS. All rights reserved.