Zhang X Y, Wang Z Q, Zhang Y, Sun X G
Beijing Institute of Ophthalmology, Beijing Tongren Ophthalmic Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China.
Zhonghua Yan Ke Za Zhi. 2016 Mar;52(3):174-9. doi: 10.3760/cma.j.issn.0412-4081.2016.03.006.
To summarize the clinical characteristics, diagnosis, and treatment of blepharokeratoconjunctivitis (BKC).
Retrospective analysis. One hundred and seventy-two patients were diagnosed as BKC between January 2012 and December 2014 at Beijing Tongren Hospital. The clinical characteristics, the degrees of blepharitis and BKC, and the therapeutic effect were evaluated.
The patients were aged from 2 to 78 years (mean, 27±18 years). Forty-nine patients (28.5%) were males, and 123 patients (71.5%) were females. One hundred and five patients had photograph records of lid margin, cornea, and conjunctiva. BKC was unilateral in 28 (26.7%) of them, and bilateral in 68 (64.8%) with similar degrees and in 9 (8.6%) with different degrees. The disease was mild in 39 patients (40.6%), moderate in 24 patients (25.0%), and severe in 33 patients (34.4%). There was no significant difference in the degree of BKC between males and females (χ(2)=1.022, P=0.600). A total of 1 875 patients were diagnosed as blepharitis during the same period, and 172 patients (9.2%) were complicated by BKC. Female patients with blepharitis were more susceptible to BKC (χ(2)=8.355, P<0.05). Among the children patients with blepharitis, the incidence of BKC was significantly higher than that in the other groups (χ(2)=224.566, P< 0.05), but in the degree of BKC, there was no significant difference among groups. Typical clinical findings consisted of punctuate epithelial and subepithelial haze, stromal infiltrates, corneal ulcer, corneal scar, and corneal pannus. The patients were followed up for 1 to 80 months (mean, 7 months). According to the different degrees of BKC, the patients were given treatment for 1 month. Sixty-nine patients (71.9%) had clinical recovery, and the other cases were improved obviously. Nine patients (15 eyes) had recurred BKC during the follow-up period, and the recurrence rate was 9.2%.
BKC is not uncommon in patients suffering blepharitis, with a variety of clinical characteristics. Female and children patients with blepharitis are more susceptible to BKC. It is vital to perform standardized diagnosis and treatment for improvement of therapeutic effect.
总结睑缘角膜结膜炎（BKC）的临床特征、诊断及治疗方法。
回顾性分析。2012年1月至2014年12月在北京同仁医院被诊断为BKC的172例患者。对其临床特征、睑缘炎和BKC的程度以及治疗效果进行评估。
患者年龄从2岁至78岁（平均27±18岁）。男性49例（28.5%），女性123例（71.5%）。105例患者有睑缘、角膜和结膜的照片记录。其中28例（26.7%）为单侧BKC，68例（64.8%）为双侧且程度相似，9例（8.6%）为双侧且程度不同。疾病轻度39例（40.6%），中度24例（25.0%），重度33例（34.4%）。男性和女性BKC程度差异无统计学意义（χ(2)=1.022，P=0.600）。同期共诊断睑缘炎患者1875例，其中172例（9.2%）并发BKC。患睑缘炎的女性患者更易患BKC（χ(2)=8.355，P<0.05）。在患睑缘炎的儿童患者中，BKC的发病率显著高于其他组（χ(2)=224.566，P<0.05），但在BKC程度上，各组间差异无统计学意义。典型临床体征包括点状上皮及上皮下混浊、基质浸润、角膜溃疡、角膜瘢痕及角膜血管翳。患者随访1至80个月（平均7个月）。根据BKC的不同程度，对患者进行1个月的治疗。69例（71.9%）临床痊愈，其他病例明显改善。9例（15眼）在随访期间BKC复发，复发率为9.2%。
BKC在睑缘炎患者中并不少见，具有多种临床特征。患睑缘炎的女性和儿童患者更易患BKC。进行规范的诊断和治疗对提高治疗效果至关重要。
