Trufanov S V, Shakhbazyan N P
Research Institute of Eye Diseases, 11A, В Rossolimo St., Moscow, Russian Federation, 119021.
Vestn Oftalmol. 2018;134(3):121-128. doi: 10.17116/oftalma20181343121.
Rosacea is a multifactorial chronic inflammatory disease with various clinical manifestations. Primarily it is seen as a dermatological condition, but it's not uncommon for it to develop ophthalmological implications affecting eyelids, cornea and conjunctiva. The article describes main aspects of its etiopathogenesis, variations in its clinical course and treatment approaches. There is currently no universal treatment strategy for the disease due to its varying clinical manifestation, particularly of its ophthalmological form, differing severity of the pathological process, lack of knowledge about its etiology and pathogenesis. Leading role in its pathological process belongs to disturbance of regulatory mechanisms of the vascular, immune and nervous systems. Additionally, higher levels of metalloproteinases and vascular endothelial growth factor (VEGF) can be observed. Possible influence of a range of micro-organisms also hasn't been excluded. Basic therapy involves both systemic and topical drugs. The first include tetracycline antibiotics. A new direction in Rosacea treatment that aims at structural and functional restoration of vascular endothelium, improvement of microcirculation and recovery of rheological properties of blood is angioprotector therapy, in particular with Calcium Dobesilate (Doxi-Hem). Aside from systemic drugs, the ophthalmological forms of Rosacea are treated topically with anti-inflammatory preparations, immunosuppressants and artificial tears that are chosen depending on the symptoms' severity. In cases with heavy corneal damage, various types of keratoplasty can be performed. Collaboration between ophthalmology and dermatology specialists is necessary in order to choose adequate strategy for Rosacea treatment.
酒渣鼻是一种具有多种临床表现的多因素慢性炎症性疾病。它主要被视为一种皮肤病,但它发展为影响眼睑、角膜和结膜的眼科疾病也并不罕见。本文描述了其病因发病机制的主要方面、临床病程的变化以及治疗方法。由于其临床表现各异,尤其是眼科形式,病理过程的严重程度不同,以及对其病因和发病机制缺乏了解,目前尚无针对该疾病的通用治疗策略。其病理过程中的主要作用属于血管、免疫和神经系统调节机制的紊乱。此外,还可观察到金属蛋白酶和血管内皮生长因子(VEGF)水平升高。一系列微生物的可能影响也未被排除。基础治疗包括全身用药和局部用药。前者包括四环素类抗生素。酒渣鼻治疗的一个新方向是血管保护疗法,特别是使用羟苯磺酸钙(多贝斯),旨在恢复血管内皮的结构和功能、改善微循环以及恢复血液的流变学特性。除全身用药外,酒渣鼻的眼科形式需根据症状严重程度局部使用抗炎制剂、免疫抑制剂和人工泪液进行治疗。在角膜严重受损的情况下,可进行各种类型的角膜移植术。为了选择合适的酒渣鼻治疗策略,眼科和皮肤科专家之间的合作是必要的。