Dong Yanling, Zhang Yangyang, Xie Lixin, Ren Jianmei
*College of Medicine, Qingdao University, Qingdao, China; †Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao, China; and ‡School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, China.
Cornea. 2017 Feb;36(2):202-209. doi: 10.1097/ICO.0000000000001084.
To investigate risk factors, clinical features, and treatment outcomes of recurrent Mooren ulcers in China.
Medical records of 139 patients (173 eyes) with Mooren ulcers, including 37 patients (38 eyes) with recurrence, were retrospectively reviewed. Clinical features and treatment outcomes were evaluated. The risk factors for ulcer recurrence were analyzed with logistic regression; the cumulative risk of recurrence was assessed with Kaplan-Meier analysis.
The ratio of males to females with Mooren ulcers was 1.62:1. As to age, 32 of 106 patients aged >35 years and 5 of 33 younger patients (28 males and 9 females) had recurrence. Forty-one patients had bilateral disease (7 eyes removed before their visit to our hospital were excluded) and 98 patients had unilateral disease, with recurrence in 10 and 27 patients, respectively. Thirty eyes had recurrence around the primary lesion; 27 eyes had recurrence within 12 months after treatment. Of all eyes, 97.7% were saved and 81.5% retained vision better than 0.05. The cumulative risk of first recurrence at 6, 12, 24, 36, and 48 months was 10.4%, 17.1%, 22.5%, 27.2%, and 28.6%, respectively. Male sex (P = 0.043) and surgical treatment (P = 0.035) were significantly associated with an increased risk of recurrence.
This study provided the clinical characteristics and treatment outcomes of patients with recurrent Mooren ulcers in China. The cumulative risk of first recurrence at 4 years after treatment was 28.6%. Male patients and patients with severe ulcers that required surgery had an increased risk of recurrence.
探讨中国复发性蚕蚀性角膜溃疡的危险因素、临床特征及治疗效果。
回顾性分析139例(173眼)蚕蚀性角膜溃疡患者的病历,其中包括37例(38眼)复发患者。评估临床特征及治疗效果。采用逻辑回归分析溃疡复发的危险因素;用Kaplan-Meier分析评估复发的累积风险。
蚕蚀性角膜溃疡患者男女比例为1.62:1。年龄方面,106例年龄>35岁的患者中有32例复发,33例较年轻患者(28例男性和9例女性)中有5例复发。41例患者为双眼患病(排除7例在来我院就诊前已摘除眼球的患者),98例患者为单眼患病,分别有10例和27例复发。30眼在原发病灶周围复发;27眼在治疗后12个月内复发。所有患眼中,97.7%的眼球得以保留,81.5%的患者视力保留在0.05以上。在6、12、24、36和48个月时首次复发的累积风险分别为10.4%、17.1%、22.5%、27.2%和28.6%。男性(P = 0.043)和手术治疗(P = 0.035)与复发风险增加显著相关。
本研究提供了中国复发性蚕蚀性角膜溃疡患者的临床特征及治疗效果。治疗后4年首次复发的累积风险为28.6%。男性患者以及需要手术治疗的重症溃疡患者复发风险增加。