Cornea and Anterior Segment Services, Tej Kohli Cornea Institute, L V Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, India.
Cornea and Anterior Segment Services, Tej Kohli Cornea Institute, L V Prasad Eye Institute, Hyderabad, India.
Am J Ophthalmol. 2018 Apr;188:99-103. doi: 10.1016/j.ajo.2018.01.020. Epub 2018 Jan 31.
To determine the demographic features of patients affected by limbal stem cell deficiency (LSCD), and to identify the underlying causes of LSCD.
Retrospective, multicenter case series.
Two large tertiary care ophthalmology hospitals.
Patients with a diagnosis of LSCD presenting from January 1, 2005 to December 31, 2014.
Records of patients with a clinical diagnosis of LSCD were reviewed. Demographic details and clinical features at presentation, as well as the underlying cause of LSCD (if identified), were noted. Descriptive statistical analysis and chart preparation were done. Main outcome measures were type of LSCD (unilateral or bilateral), age and sex of patients, extent of LSCD (clock hours of limbus involved), and underlying cause of LSCD.
We found 1331 patients with LSCD in the 10-year period under study. Unilateral LSCD was more common (791 patients) than bilateral LSCD (540 patients). Out of 1331 patients, 875 (65.74%) were male. The median age of patients was 24 years. Extent of LSCD could be determined in 1849 eyes, of which 1239 eyes (67.00%) had total LSCD. The underlying cause of LSCD could be identified in 1512 eyes. In cases of unilateral LSCD, ocular surface burns was the commonest identifiable cause (83.73%). The leading identifiable causes of bilateral LSCD were ocular surface burns (29.95%), allergic conjunctivitis (29.48%), Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) (23.11%), aniridia (9.43%), and mucous membrane pemphigoid (3.54%). Lime ("chuna") injury was responsible for ocular surface burns in 352 out of 567 cases in which the agent was identified (62.08%).
In our study, unilateral LSCD was more common than bilateral LSCD. Young male subjects were commonly affected, with a majority of eyes suffering from total LSCD. Overall, ocular surface burns are the leading cause of LSCD. Unilateral and bilateral LSCD had a markedly different distribution of causes, necessitating different approaches to management.
确定患有边缘干细胞缺乏症（LSCD）的患者的人口统计学特征，并确定 LSCD 的根本原因。
回顾性、多中心病例系列研究。
两家大型三级眼科护理医院。
2005 年 1 月 1 日至 2014 年 12 月 31 日期间诊断为 LSCD 的患者。
回顾有临床诊断 LSCD 的患者的记录。记录人口统计学细节和初诊时的临床特征，以及 LSCD 的根本原因（如已确定）。进行描述性统计分析和图表编制。主要观察指标为 LSCD 的类型（单侧或双侧）、患者的年龄和性别、LSCD 的程度（涉及的角膜缘时钟小时数）和 LSCD 的根本原因。
在研究的 10 年期间，我们发现 1331 例 LSCD 患者。单侧 LSCD 比双侧 LSCD 更常见（791 例比 540 例）。在 1331 例患者中，875 例（65.74%）为男性。患者的中位年龄为 24 岁。在 1849 只眼中可以确定 LSCD 的程度，其中 1239 只眼（67.00%）存在完全 LSCD。在 1512 只眼中可以确定 LSCD 的根本原因。在单侧 LSCD 中，眼表烧伤是最常见的可识别原因（83.73%）。导致双侧 LSCD 的主要可识别原因是眼表烧伤（29.95%）、过敏性结膜炎（29.48%）、史蒂文斯-约翰逊综合征（SJS）或中毒性表皮坏死松解症（TEN）（23.11%）、无虹膜（9.43%）和黏膜类天疱疮（3.54%）。在确定药物的 567 例石灰（“chuna”）损伤病例中，有 352 例（62.08%）眼表烧伤是由石灰引起的。
在我们的研究中，单侧 LSCD 比双侧 LSCD 更常见。年轻男性受影响更为常见，大多数眼睛患有完全 LSCD。总体而言，眼表烧伤是 LSCD 的主要原因。单侧和双侧 LSCD 的病因分布明显不同，需要采用不同的管理方法。
