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肺炎球菌性角膜炎病例的角膜胶原交联治疗

Corneal Collagen Crosslinking Treatment in a Case with Pneumococcal Keratitis.

作者信息

Bozkurt Oflaz Ayşe, Bozkurt Banu, Kamış Ümit, Ekinci Köktekir Bengü

机构信息

Selçuk University Faculty of Medicine, Department of Ophthalmology, Konya, Turkey.

出版信息

Turk J Ophthalmol. 2017 Jun;47(3):161-164. doi: 10.4274/tjo.98470. Epub 2017 Jun 1.

DOI:10.4274/tjo.98470
PMID:28630792
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5468530/
Abstract

Bacterial keratitis is a serious ocular infectious disease that can threaten vision. The disease generally progresses rapidly and can lead to corneal scar, stromal abscess formation, perforation, and dissemination to adjacent tissues if not treated properly. Recent studies showed that corneal collagen crosslinking (CCC) using ultraviolet-A/riboflavin is effective in the treatment of bacterial keratitis refractory to topical antibiotic treatment. In addition to being bactericidal, CCC also decreases risk of perforation by strengthening the corneal collagen structure. Herein, we report a male patient with Streptococcus pneumonia keratitis 6 months after a keratoplasty procedure, which did not respond to fortified topical antibiotic therapy and was treated successfully with riboflavin/ultraviolet-A CCC. His pain decreased remarkably in a few days. The corneal epithelial defect healed and infiltration regressed within 2 weeks after CCC. His vision improved significantly from hand movement to 20/400. CCC might be used as adjuvant treatment in bacterial keratitis refractory to medical treatment.

摘要

细菌性角膜炎是一种严重的眼部感染性疾病，可威胁视力。该病通常进展迅速，若治疗不当，可导致角膜瘢痕、基质脓肿形成、穿孔，并扩散至邻近组织。最近的研究表明，使用紫外线A/核黄素进行角膜胶原交联（CCC）对局部抗生素治疗无效的细菌性角膜炎有效。除具有杀菌作用外，CCC还通过强化角膜胶原结构降低穿孔风险。在此，我们报告1例男性患者，在角膜移植术后6个月发生肺炎链球菌性角膜炎，强化局部抗生素治疗无效，采用核黄素/紫外线A CCC治疗成功。数天内其疼痛显著减轻。CCC治疗后2周内角膜上皮缺损愈合，浸润消退。其视力从手动显著提高到20/400。CCC可作为药物治疗无效的细菌性角膜炎的辅助治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea9e/5468530/8c3a2db094fa/TJO-47-161-g5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea9e/5468530/a153acce63fe/TJO-47-161-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea9e/5468530/3ef9adf77654/TJO-47-161-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea9e/5468530/6f6dd9f56823/TJO-47-161-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea9e/5468530/9c5c3c381ead/TJO-47-161-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea9e/5468530/8c3a2db094fa/TJO-47-161-g5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea9e/5468530/a153acce63fe/TJO-47-161-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea9e/5468530/3ef9adf77654/TJO-47-161-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea9e/5468530/6f6dd9f56823/TJO-47-161-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea9e/5468530/9c5c3c381ead/TJO-47-161-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea9e/5468530/8c3a2db094fa/TJO-47-161-g5.jpg

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本文引用的文献

1
A case of medication-resistant acanthamoeba keratitis treated by corneal crosslinking in Turkey.土耳其一例经角膜交联治疗的耐药物棘阿米巴角膜炎病例。
Case Rep Ophthalmol Med. 2013;2013:608253. doi: 10.1155/2013/608253. Epub 2013 Dec 22.
2
Corneal collagen crosslinking and herpetic keratitis.角膜胶原交联与疱疹性角膜炎
J Cataract Refract Surg. 2013 Aug;39(8):1281. doi: 10.1016/j.jcrs.2013.06.002.
3
Collagen cross-linking and corneal infections.胶原交联和角膜感染。
Curr Opin Ophthalmol. 2013 Jul;24(4):288-90. doi: 10.1097/ICU.0b013e32836229c5.
4
Impending corneal perforation after collagen cross-linking for herpetic keratitis.疱疹性角膜炎行胶原交联术后即将发生的角膜穿孔。
J Cataract Refract Surg. 2013 Apr;39(4):638-41. doi: 10.1016/j.jcrs.2013.02.006.
5
Photoactivated riboflavin treatment of infectious keratitis using collagen cross-linking technology.采用胶原交联技术的光激活核黄素治疗感染性角膜炎。
J Refract Surg. 2012 Oct;28(10):706-13. doi: 10.3928/1081597X-20120921-06.
6
Treatment of fungal keratitis from Fusarium infection by corneal cross-linking.交联治疗镰刀菌感染性真菌性角膜炎。
Cornea. 2012 Feb;31(2):176-80. doi: 10.1097/ICO.0b013e318221cec7.
7
Assessing efficacy of combined riboflavin and UV-A light (365 nm) treatment of Acanthamoeba trophozoites.评估核黄素与 UV-A 光（365nm）联合治疗棘阿米巴滋养体的疗效。
Invest Ophthalmol Vis Sci. 2011 Dec 9;52(13):9333-8. doi: 10.1167/iovs.11-8382.
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UVA-riboflavin photochemical therapy of bacterial keratitis: a pilot study.UVA-核黄素光化学疗法治疗细菌性角膜炎：一项初步研究。
Graefes Arch Clin Exp Ophthalmol. 2012 Jan;250(1):95-102. doi: 10.1007/s00417-011-1754-1. Epub 2011 Aug 27.
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Infectious keratitis treated with corneal crosslinking.经角膜交联术治疗的感染性角膜炎。
Cornea. 2010 Dec;29(12):1353-8. doi: 10.1097/ICO.0b013e3181d2de91.
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J Refract Surg. 2010 May;26(5):375-7. doi: 10.3928/1081597X-20100114-03.