Parikh Rupin N, Sandhu Harpal S, Massaro-Giordano Giacomina, Goldstein Scott M, OʼBrien Joan M
Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA.
Albany Medical College, Albany, NY.
Cornea. 2018 Feb;37(2):255-257. doi: 10.1097/ICO.0000000000001452.
To describe a case of reactive lymphoid hyperplasia (RLH) of the conjunctiva responding to cyclosporine immunosuppressant monotherapy.
A 66-year-old man with a 2-year history of biopsy-proven bilateral RLH presented for dry eye evaluation with chief complaints of burning, stinging, and irritation in both eyes. After slit-lamp examination and positive findings of matrix metalloproteinase 9 in the patient's tear film, he was diagnosed with meibomian gland dysfunction and tear-insufficiency dry eye disease. The patient was subsequently treated with topical cyclosporine (ophthalmic emulsion 0.5 mg/mL two times per day) in both eyes.
Examination at the 3-month follow-up visit revealed significant reduction of the RLH lesions bilaterally.
This report represents the first case of benign ocular RLH responsive to topical cyclosporine therapy. We believe that cyclosporine could play a role in treating patients with benign ocular RLH and warrants further investigation to evaluate its full efficacy.
描述一例结膜反应性淋巴组织增生(RLH)对环孢素免疫抑制剂单一疗法有反应的病例。
一名66岁男性,有经活检证实的双侧RLH病史2年,因双眼烧灼感、刺痛和刺激感为主诉前来进行干眼评估。裂隙灯检查及患者泪膜中基质金属蛋白酶9呈阳性结果后,他被诊断为睑板腺功能障碍和泪液不足性干眼病。该患者随后接受了双眼局部使用环孢素(0.5 mg/mL眼用乳剂,每日两次)的治疗。
3个月随访检查显示双侧RLH病变显著减轻。
本报告代表了首例对局部环孢素治疗有反应的良性眼部RLH病例。我们认为环孢素在治疗良性眼部RLH患者中可能发挥作用,值得进一步研究以评估其全部疗效。