Kılıç Müftüoğlu İlkay, Aydın Akova Yonca
İstanbul Training and Research Hospital, Ophthalmology Clinic, İstanbul, Turkey.
Bayındır Kavaklıdere Hospital, Ophthalmology Clinic, Ankara, Turkey.
Turk J Ophthalmol. 2016 Jan;46(1):1-6. doi: 10.4274/tjo.48902. Epub 2016 Jan 5.
To report the clinical features, treatment options and complications in patients with ocular rosacea.
The records of 48 eyes of 24 patients with ocular rosacea were retrospectively reviewed. Patients' ocular signs and symptoms were scored between 1 and 4 points according to disease severity; tear film break-up time (BUT) and Schirmer's test results were recorded before and after the treatment. Preservative-free artificial tears, topical antibiotic eye drops/ointments, short-term topical corticosteroids, topical 0.05% cyclosporine and oral doxycycline treatment were applied as a standard therapy to all patients. Additional treatments were given as needed. Complications were recorded.
Twenty-four patients with a mean age of 48.5±35.4 (32-54) years were followed for a mean 15±9.4 (8-36) months. Ocular findings included meibomitis in 100% of cases, anterior blepharitis in 83% (40 eyes), punctate keratopathy in 67% (32 eyes), chalazia in 50% (24 eyes), corneal neovascularization in 50% (24 eyes) and subepithelial infiltrates in 16.6% (8 eyes). Significant improvement of symptoms and clinical findings were achieved in all patients with treatment. The increases in Schirmer's test and BUT were 3.3±1.5 and 4.5±2.8, respectively (p<0.05). Descemetocele and small corneal perforation occurred in 2 eyes; re-epithelialization was achieved in both eyes with tissue adhesive application (1 eye) and additional amniotic membrane transplantation (1 eye). Four eyes of three patients showed significant regression of corneal neovascularization with topical bevacizumab therapy.
Ocular rosacea may present with a variety of ophthalmic signs. It is possible to control the ophthalmic disease with appropriate therapeutic modalities including topical corticosteroids, topical cyclosporine and systemic doxycycline.
报告眼部酒渣鼻患者的临床特征、治疗选择及并发症。
回顾性分析24例眼部酒渣鼻患者48只眼的病历资料。根据疾病严重程度,对患者的眼部体征和症状进行1至4分的评分;记录治疗前后的泪膜破裂时间(BUT)和泪液分泌试验结果。所有患者均采用无防腐剂人工泪液、局部抗生素滴眼液/眼膏、短期局部糖皮质激素、局部0.05%环孢素和口服多西环素作为标准治疗。根据需要给予额外治疗。记录并发症情况。
24例患者,平均年龄48.5±35.4(32 - 54)岁,平均随访15±9.4(8 - 36)个月。眼部表现包括:睑板腺炎100%,前部睑缘炎83%(40只眼),点状角膜病变67%(32只眼),睑板腺囊肿50%(24只眼),角膜新生血管50%(24只眼),上皮下浸润16.6%(8只眼)。所有患者经治疗后症状和临床体征均有显著改善。泪液分泌试验和BUT的增加分别为3.3±1.5和4.5±2.8(p<0.05)。2只眼发生了后弹力层膨出和小的角膜穿孔;1只眼通过应用组织黏合剂,另1只眼通过额外的羊膜移植实现了上皮再形成。3例患者的4只眼经局部应用贝伐单抗治疗后角膜新生血管显著消退。
眼部酒渣鼻可能表现出多种眼部体征。通过包括局部糖皮质激素、局部环孢素和全身多西环素在内的适当治疗方式,有可能控制眼部疾病。