Conjuntivitis Folicular Aguda

a r c h s o c e s p o f t a l m o l .
2 0 1 5;9 0(8):389–391
ARCHIVOS DE LA SOCIEDAD
ESPAÑOLA DE OFTALMOLOGÍA
www.elsevier.es/oftalmologia
Short communication
Diagnosis of acute follicular conjunctivitis: A 5-year

retrospective analysis in a referral center夽,夽夽
J.C. Serna-Ojeda ∗ , P. Nuñez-Rivera, J. Quevedo-Martínez, M. Álvarez-López

Instituto de Oftalmología «Conde de Valenciana», Mexico City, Mexico
a r t i c l e i n f o a b s t r a c t
Article history: Objective and methods: A retrospective analysis was performed using the medical records in
Received 26 May 2014 a referral center in Mexico over a period of 5 years, in order to determine the frequency of
Accepted 3 November 2014 acute follicular conjunctivitis.
Available online 28 August 2015 Results and conclusions: A total of 859,986 ophthalmology consultations were given, from
which 8,930 were diagnosed with acute follicular conjunctivitis (1.03% of the total). The
Keywords: number of patients diagnosed range between 100 and 200 in the majority of months. In
Acute follicular conjunctivitis August 2012 an increase was observed with 308 cases, and then decreasing after two months.
Follicular conjunctivitis This study did not demonstrate a highest frequency by month, with exception of year 2012
Conjunctivitis that showed a peak incidence in the third trimester.
Mexico city © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights
Monthly distribution reserved.
Diagnóstico de conjuntivitis folicular aguda: un análisis retrospectivo

de 5 años en un centro de referencia
r e s u m e n
Palabras clave: Objetivo y métodos: Para determinar la frecuencia de la conjuntivitis folicular aguda, se anal-
Conjuntivitis folicular aguda izó de manera retrospectiva los expedientes médicos en un centro de referencia en México
Conjuntivitis folicular durante un periodo de 5 años.
Conjuntivitis Resultados y conclusiones: Un total de 859.986 consultas oftalmológicas fueron otorgadas, de
Ciudad de México las cuales 8.930 fueron diagnosticadas con conjuntivitis folicular aguda (1,03% del total).
Distribución mensual En la mayoría de los meses hubo un rango entre 100 y 200 pacientes. En agosto de 2012 se
夽
Please cite this article as: Serna-Ojeda JC, Nuñez-Rivera P, Quevedo-Martínez J, Álvarez-López M. Diagnóstico de conjuntivitis folicular
aguda: un análisis retrospectivo de 5 años en un centro de referencia. Arch Soc Esp Oftalmol. 2015;90:389–391.
夽夽
Paper presented at the annual meeting of the Association for Research in Vision and Ophthalmology (ARVO), May 2014, Orlando, FL,
United States.
∗
Corresponding author.
E-mail address: [email protected] (J.C. Serna-Ojeda).
2173-5794/© 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.
390 a r c h s o c e s p o f t a l m o l . 2 0 1 5;9 0(8):389–391
observó un aumento con 308 casos, disminuyendo después de 2 meses. Nuestro estudio no
demostró una mayor frecuencia por mes, con excepción del año 2012 que presentó un pico
en la incidencia durante el tercer trimestre.
© 2014 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. Todos
los derechos reservados.
400
Introduction 2008
2009
2010
Even though acute follicular conjunctivitis can have several 300 2011
Number of diagnostics
2012
etiologies,1 conjunctivitis due to adenovirus is the most fre-
quent cause of viral and infectious conjunctivitis2 and is a
frequent reason for ophthalmological consultations. 200
Follicular conjunctivitis due to adenovirus causes epidemic

outbreaks in hospitals and communities as well as significant
economic loss due to labor disability.3,4 The distribution of this 100
infectious conjunctivitis can follow several patterns through-

out the year, although this is not clearly defined. The objective
0
of this study is to determine the amount of acute follicular con- January March May July September November
junctivitis in a referral ophthalmological institution in Mexico
City in the course of 5 years, and analyzing the monthly dis- Fig. 1 – Monthly distribution of acute follicular
tribution thereof. conjunctivitis diagnostic throughout the five-year period.
Material and methods

The majority of patients, 8832 (98.9%) were defined only
A clinical and retrospective study was carried out in the as acute follicular conjunctivitis without mention of a specific
«Conde de Valenciana» Ophthalmology Institute, reviewing syndrome or etiological suspicion.
diagnostics in the hospital system of the institution cov- The monthly distribution of acute follicular conjunctivitis
ering a five-year period (January 1, 2008 to December 31, diagnostic in the course of the 5 years of the study is shown
2012). Inclusion criteria: patients of both sexes with a diag- in Fig. 1. It can be seen that in most months there is a range
nostic of acute follicular conjunctivitis. Exclusion criteria: between 100 and 200 diagnostics. The month with the lowest
patients with a diagnostic of acute follicular conjunctivitis amount of diagnostics was November 2008 with 85 diagnos-
due to other infectious agents such as primary herpes sim- tics. In contrast, August 2012 exhibited a peak in the amount
plex, herpes zoster, acute trachoma among others, as well of diagnostics (308) which diminished 2 months later to 190 in
as non-infectious causes such as toxic conjunctivitis caused October 2012.
by medication. Elimination criteria: consecutive diagnostics To determine any tendency regarding the monthly distri-
of the same patients 2 months after the first diagnostic or bution of acute follicular conjunctivitis, a graft was made with
those consisting in consecutive consultations for the same
infectious condition. The result was that the majority of the 1000 931
remaining diagnostics were acute follicular conjunctivitis due
to adenovirus, with diagnostic based on clinical examination. 790
785 757
762 762
Percentages were calculated by means of descriptive statis- 750
727 721
739
tics for categorical variables, while for numerical variables 689
Overall number of diagnostics per month
650 617
the central, mean or median tendency was used accord-
ing to distribution. Data were represented in tables and
500
figures.
250
Results
Within said five-year period, 859,986 consultations were pro-

0
vided by the institution of which 8930 were for acute follicular
conjunctivitis, accounting for 1.03% of ophthalmological con- January April July October
sultations. Overall, 5314 (59%) of patients were female and
3616 (41%) were male. The mean age was 44 years (range: Fig. 2 – Overall distribution per month of acute follicular
0–97 years). conjunctivitis throughout the five-year period.
a r c h s o c e s p o f t a l m o l . 2 0 1 5;9 0(8):389–391 391
the overall monthly amount covering said 5 years. The results

are shown in Fig. 2.
Conflict of interests
No conflict of interests has been declared by the authors.
Discussion references
The data presented herein on the distribution of acute fol-

licular conjunctivitis in a five-year period demonstrate that, 1. Jackson WB. Differentiating conjunctivitis of diverse origins.
Surv Ophthalmol. 1993;38 Suppl:91–104.
despite some reports indicating higher frequency of this
2. Sambursky RP, Fram N, Cohen EJ. The prevalence of adenoviral
condition in some month due to higher temperature and conjunctivitis at the Wills Eye Hospital Emergency Room.
humidity,5 or in winter due to more closeness between people, Optometry. 2007;78:236–9.
the present study did not reveal seasonal peaks. A sim- 3. Cheung D, Bremner J, Chan JT. Epidemic kerato-conjunctivitis –
ilar monthly frequency was found, with the exception of do outbreaks have to be epidemic? Eye (Lond). 2003;17:356–63.
2012 which exhibited a higher number of diagnostics in the 4. Buehler JW, Finton RJ, Goodman RA, Choi K, Hierholzer JC,
Sikes RK, et al. Epidemic keratoconjunctivitis: report of an
third quarter. The limitations of this study are the inclu-
outbreak in an ophthalmology practice and recommendations
sion of exclusively clinical diagnostics without laboratory
for prevention. Infect Control. 1984;5:390–4.
confirmation and the possibility that the acute follicular 5. Aoki K, Tagawa Y. A twenty-one year surveillance of adenoviral
conjunctivitis diagnostic was applied excessively to visiting conjunctivitis in Sapporo, Japan. Int Ophthalmol Clin.
patients. 2002;42:49–54.

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a r c h s o c e s p o f t a l m o l .

Diagnosis of acute follicular conjunctivitis: A 5-year

J.C. Serna-Ojeda ∗ , P. Nuñez-Rivera, J. Quevedo-Martínez, M. Álvarez-López

Diagnóstico de conjuntivitis folicular aguda: un análisis retrospectivo

Follicular conjunctivitis due to adenovirus causes epidemic

infectious conjunctivitis can follow several patterns through-

Material and methods

Within said ﬁve-year period, 859,986 consultations were pro-

the overall monthly amount covering said 5 years. The results

No conﬂict of interests has been declared by the authors.

The data presented herein on the distribution of acute fol-

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