Thanathanee Onsiri, Bhoomibunchoo Chavakij, Suwan-apichon Olan
Department of Ophthalmology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand.
BMJ Case Rep. 2014 Nov 19;2014:bcr2014206401. doi: 10.1136/bcr-2014-206401.
A 6-year-old Thai girl presented with itching, redness and copious discharge in both eyes. Slit-lamp biomicroscopy of the left eye revealed cobblestone papillae with marked ptosis while in the right eye only small papillae were observed. Punctuate epithelial keratitis was noted only in the left eye. There were no associated factors for giant papillary conjunctivitis (ie, suture or contact lens). The cobblestone papillae in the left eye persisted after maximal topical and oral antiallergic medications. Two doses of supratarsal corticosteroid (20 mg of triamcinolone acetonide) injection without any topical or oral antiallergic medications were undertaken in the left eye 1 month apart. Cobblestone papillae and punctate epithelial erosion (including allergic symptoms) were completely recovered. There was no recurrence after 18 months of follow-up. This case report indicates that using supratarsal corticosteroid injection by itself in recalcitrant vernal keratoconjunctivitis provides promising results.
一名6岁泰国女孩双眼出现瘙痒、发红及大量分泌物。左眼裂隙灯生物显微镜检查显示有鹅卵石样乳头并伴有明显上睑下垂，而右眼仅观察到小乳头。仅左眼出现点状上皮角膜炎。不存在与巨乳头性结膜炎相关的因素（如缝线或隐形眼镜）。在使用最大剂量的局部和口服抗过敏药物后，左眼的鹅卵石样乳头仍然存在。左眼在相隔1个月的时间里接受了两剂睑板上皮质类固醇（20毫克曲安奈德）注射，未使用任何局部或口服抗过敏药物。鹅卵石样乳头和点状上皮糜烂（包括过敏症状）完全恢复。随访18个月后无复发。本病例报告表明，对于难治性春季角结膜炎单独使用睑板上皮质类固醇注射可取得良好效果。
