Eiseman Andrew S, Flanagan Joseph C, Brooks Alfred B, Mitchell Edith P, Pemberton Clifford H
Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
Ophthalmic Plast Reconstr Surg. 2003 May;19(3):216-24. doi: 10.1097/01.iop.0000066648.33513.3d.
To determine the prevalence rates and associated characteristics of patients who have ocular surface, ocular adnexal, and lacrimal complications associated with the systemic use of the cancer chemotherapeutic agent 5-Fluorouracil (5-FU).
An exposure-based cohort study was designed. Adult patients who had completed at least 3 months of systemic 5-FU therapy within the past 5 years were eligible for enrollment. Study subjects had a detailed medical history taken with emphasis on preexisting conditions known to be associated with the development of ocular surface, ocular adnexal, and lacrimal complications. An ocular examination was then performed. A complete nasolacrimal system evaluation was performed if symptoms or findings were identified. The prevalence was then determined for each ocular symptom and each ocular finding identified that was not present pretreatment. An exploratory analysis was then performed to identify patient characteristics that might influence the likelihood of developing any of the above complications.
Fifty-two patients were enrolled in the study. The prevalence rates of the following ocular abnormalities were calculated: ocular irritation, 5.8%; blepharitis, 3.8%; conjunctivitis, 3.8%; keratitis, 3.8%; eyelid dermatitis, 5.8%; cicatricial ectropion, 1.9%; tearing, 26.9%; punctal-canalicular stenosis, 5.8%; and blurred vision, 11.5%. Blacks had tearing at a significantly higher rate when compared with whites (P = 0.022, 2-sided Fisher exact test). Three patients had permanent complications that will require surgery for correction. Of the 7 patients who had a single abnormality, 6 had tearing and one had eyelid dermatitis. All of the 8 patients who had multiple findings had tearing as one of their abnormalities.
Ninety-three percent of the patients who had an ocular abnormality had tearing as one of the complications. Patients who are receiving systemic 5-FU and begin to tear should have an ocular examination, looking for ocular surface, ocular adnexal, and lacrimal complications.
确定与全身使用癌症化疗药物5-氟尿嘧啶（5-FU）相关的眼表、眼附属器和泪道并发症患者的患病率及相关特征。
设计了一项基于暴露的队列研究。在过去5年内完成至少3个月全身5-FU治疗的成年患者符合入组条件。研究对象详细记录病史，重点关注已知与眼表、眼附属器和泪道并发症发生相关的既往疾病。然后进行眼科检查。如果发现症状或体征，则进行完整的鼻泪系统评估。然后确定每种眼症状和每种检查发现的、治疗前不存在的患病率。然后进行探索性分析，以确定可能影响发生上述任何并发症可能性的患者特征。
52例患者纳入研究。计算出以下眼部异常的患病率：眼刺激感5.8%；睑缘炎3.8%；结膜炎3.8%；角膜炎3.8%；眼睑皮炎5.8%；瘢痕性睑外翻1.9%；流泪26.9%；泪点-泪小管狭窄5.8%；视力模糊11.5%。与白人相比，黑人流泪发生率显著更高（P = 0.022，双侧Fisher精确检验）。3例患者有永久性并发症，需要手术矫正。在7例有单一异常的患者中，6例流泪，1例有眼睑皮炎。8例有多种检查发现的患者均有流泪作为其异常之一。
93%有眼部异常的患者有流泪作为并发症之一。接受全身5-FU治疗且开始流泪的患者应进行眼科检查，查找眼表、眼附属器和泪道并发症。
