Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.; Present address: Department of Ophthalmology, Kochi Medical School, Kochi, Japan..
Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
Allergol Int. 2010 Sep;59(3):309-312. doi: 10.2332/allergolint.10-CR-0185. Epub 2010 Jul 25.
Atopic and vernal keratoconjunctivitis are severe types of ocular allergic disease characterized not only by conjunctival inflammation but also by corneal involvement. In vitro studies have suggested that breakdown of corneal epithelial barrier function and subsequent activation of stromal fibroblasts may amplify ocular allergic inflammation.
A 27-year-old man with atopic dermatitis developed atopic keratoconjunctivitis including corneal ulcer with plaque deposition in his right eye. Conjunctival inflammation in the right eye was resistant to topical steroid therapy. Surgical removal of corneal plaque and administration of autologous fibronectin eyedrops resulted not only in resurfacing of the corneal epithelium but also in amelioration of conjunctival inflammation.
This case suggests that loss of corneal epithelial integrity likely exacerbates conjunctival allergic inflammation and that restoration or maintenance of the barrier function of the corneal epithelium may be one of the important targets for the treatment of severe ocular allergic diseases.
特应性和春季角结膜炎是严重的眼部过敏性疾病，其特征不仅是结膜炎症，还包括角膜受累。体外研究表明，角膜上皮屏障功能的破坏以及随后基质成纤维细胞的激活可能会放大眼部过敏炎症。
一名 27 岁的特应性皮炎患者右眼出现特应性角结膜炎，包括角膜溃疡和斑块沉积。右眼的结膜炎症对局部皮质类固醇治疗有抗药性。角膜斑块的手术切除和自体纤维连接蛋白滴眼剂的使用不仅使角膜上皮重新覆盖，而且还改善了结膜炎症。
该病例提示角膜上皮完整性的丧失可能会加重结膜过敏炎症，而角膜上皮屏障功能的恢复或维持可能是治疗严重眼部过敏性疾病的重要目标之一。
