Luk F O J, Wong V W Y, Rao S K, Lam D S C
Department of Ophthalmology & Visual Science, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China.
Eye (Lond). 2008 Aug;22(8):1011-4. doi: 10.1038/sj.eye.6702816. Epub 2007 Apr 27.
To document the disease spectrum and evaluate the presence of perilimbal conjunctival pigmentation in Chinese patients with vernal keratoconjunctivitis (VKC).
A case-control study was conducted between November 2004 and July 2005. Patients aged 18 or younger with VKC and age-matched children attending our eye clinic for refractive or orthoptic problems were recruited and compared. Detailed slit-lamp examination was performed noting in particular the presence of perilimbal conjunctival pigmentation, the severity of papillary reaction, and corneal complications of VKC.
A total of 19 patients and 23 controls were evaluated. The presence of bilateral large tarsal or limbal papillae and epithelial defect were significantly associated with symptoms severity (Fisher's exact test, P=0.015 and P=0.035 respectively). All VKC patients were found to have perilimbal conjunctival pigmentation in at least one eye. There was a significant correlation in the colour and density of pigments between the two eyes (Sperman's rho=0.93, P<0.001). None of the controls was found to have such perilimbal conjunctival pigmentation (Fisher's exact test, P<0.001).
The presence of perilimbal conjunctival pigmentation appears to be a consistent clinical finding in Chinese patients with VKC and may be a useful diagnostic sign for patients with subtle signs or symptoms.
记录中国春季角结膜炎（VKC）患者的疾病谱，并评估角膜缘结膜色素沉着情况。
于2004年11月至2005年7月进行一项病例对照研究。招募年龄在18岁及以下的VKC患者以及因屈光或视光问题到我们眼科门诊就诊的年龄匹配儿童，并进行比较。进行详细的裂隙灯检查，特别注意角膜缘结膜色素沉着的存在、乳头反应的严重程度以及VKC的角膜并发症。
共评估了19例患者和23例对照。双侧大睑裂或角膜缘乳头及上皮缺损的存在与症状严重程度显著相关（Fisher精确检验，P分别为0.015和0.035）。所有VKC患者至少一只眼中均发现有角膜缘结膜色素沉着。双眼色素的颜色和密度之间存在显著相关性（斯皮尔曼等级相关系数=0.93，P<0.001）。对照组中未发现有此类角膜缘结膜色素沉着（Fisher精确检验，P<0.001）。
角膜缘结膜色素沉着的存在似乎是中国VKC患者的一项一致临床发现，对于体征或症状不明显的患者可能是一个有用的诊断标志。
