Asena L, Şıngar Özdemir E, Burcu A, Ercan E, Çolak M, Altınörs D D
Department of Ophthalmology, Baskent University Faculty of Medicine, Ankara, Turkey.
Department of Ophthalmology, Ankara Education and Research Hospital, Ankara, Turkey.
Eye (Lond). 2017 May;31(5):781-787. doi: 10.1038/eye.2017.4. Epub 2017 Feb 3.
PurposeTo compare the clinical outcome with different treatment regimens in Acute Adenoviral Keratoconjunctivitis (AAK).MethodsThe records of 110 patients diagnosed as AAK in two tertiary eye care centers were evaluated retrospectively. The treatment regimen, follow-up duration, time until improvement of the symptoms, visual acuity, clinical findings, Schirmer's test and the Ocular Surface Disease Index (OSDI) score at the first day, first week and third week were recorded. The Kruskal-Wallis Test and Chi-square test were used for comparison of quantitative and categorical variables, respectively.ResultsForty six patients were receiving topical corticosteroids (Group 1), 32 topical 2% Cyclosporin A (CsA) (Group 2) and 32 only artificial tears (Group 3). Mean time until resolution of the symptoms was lowest in Group 1 (9.5±4.9 days) and highest in Group 3 (13.3±4.2 days)(p: 0.001). OSDI scores at the first and third weeks were highest in Group 3 (52.4±16.4 and 32.3±13.0) and lowest in Group 1 (41.0±21.3 and 23.9±13.2)(p: 0.01 and p: 0.009). At day 21, percentage of the patients with subepthelial infiltrates was the highest in Group 3 (63.4%) and lowest in Group 1 (42.5%).ConclusionsThe symptoms were less severe and had a shorter duration with topical corticosteroids and CsA when compared with palliative therapy. Topical 2% CsA may inhibit development of corneal subepithelial infiltrates when used in the acute phase of infection, similar to corticosteroids.
目的
比较急性腺病毒性角结膜炎(AAK)不同治疗方案的临床疗效。
方法
回顾性评估两家三级眼科护理中心110例诊断为AAK患者的病历。记录治疗方案、随访时间、症状改善时间、视力、临床检查结果、泪液分泌试验以及第一天、第一周和第三周的眼表疾病指数(OSDI)评分。分别采用Kruskal-Wallis检验和卡方检验比较定量变量和分类变量。
结果
46例患者接受局部皮质类固醇治疗(第1组),32例接受局部2%环孢素A(CsA)治疗(第2组),32例仅使用人工泪液(第3组)。症状缓解的平均时间在第1组最短(9.5±4.9天),在第3组最长(13.3±4.2天)(p:0.001)。第1周和第3周的OSDI评分在第3组最高(52.4±16.4和32.3±13.0),在第1组最低(41.0±21.3和23.9±13.2)(p:0.01和p:0.009)。在第21天,第3组上皮下浸润患者的百分比最高(63.4%),第1组最低(42.5%)。
结论
与姑息治疗相比,局部皮质类固醇和CsA治疗症状较轻,持续时间较短。局部使用2% CsA在感染急性期使用时可能抑制角膜上皮下浸润的发展,与皮质类固醇类似。