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稀释聚维酮碘治疗腺病毒性角结膜炎对角膜上皮下浸润发生率的影响。

Effect of diluted povidone iodine in adenoviral keratoconjunctivitis on the rate of subepithelial corneal infiltrates.

作者信息

Altan-Yaycioglu Rana, Sahinoglu-Keskek Nedime, Canan Handan, Coban-Karatas Muge, Ulas Burak

机构信息

Department of Ophthalmology, Baskent University School of Medicine, Adana 01130, Turkey.

出版信息

Int J Ophthalmol. 2019 Sep 18;12(9):1420-1425. doi: 10.18240/ijo.2019.09.08. eCollection 2019.

Abstract

AIM

To evaluate the clinical characteristics of adenoviral keratoconjunctivitis, the management modalities, as well as the incidence of subepithelial corneal infiltrates (SEI).

METHODS

Patients with characteristic clinical symptoms and signs, who presented to our clinic within the first week of symptoms and received the diagnosis of adenoviral keratoconjunctivitis between January 2013 and April 2016, were included in the study. A total of 211 patients were included in the study. Patients were evaluated for the incidence of clinical signs, late complications, management preferences, and the effect of diluted povidone-iodine (d-PVP-I) 2%.

RESULTS

Patients' mean age was 33.03±14.76y. We observed an increase in the number of cases according to the years. At presentation and/or early follow-up, the clinical signs were conjunctival hyperemia (100%), conjunctival follicules (79.1%), edema of the eyelids (39.3%), chemosis (16.1%), pseudomembrane formation (16.6%), and corneal epitheliopathy (29.9%). During late follow-up 13.3% patients developed conjunctival subepithelial fibrosis, and 39.8% developed SEI. A significant decrease in the incidence of SEI development was observed in patients who used d-PVP-I 2% (=0.032; 33.3% 45.9%, respectively in patients who received d-PVP-I 2% and who did not).

CONCLUSION

Adenoviral keratoconjunctivitis has a tremendous effect on patient's comfort and abilities in short-term. Additionally, almost half of the patients develop visual problems related to SEI. According to our clinical experience, using d-PVP-I 2% in the first days of adenoviral keratoconjunctivitis might be helpful in reducing the risk of SEI as a complication.

摘要

目的

评估腺病毒性角结膜炎的临床特征、治疗方式以及角膜上皮下浸润(SEI)的发生率。

方法

选取2013年1月至2016年4月期间因典型临床症状和体征于症状出现第一周内就诊并被诊断为腺病毒性角结膜炎的患者纳入研究。本研究共纳入211例患者。对患者的临床体征发生率、晚期并发症、治疗偏好以及2%稀释聚维酮碘(d-PVP-I)的效果进行评估。

结果

患者平均年龄为33.03±14.76岁。我们观察到病例数随年份有所增加。就诊时和/或早期随访时,临床体征包括结膜充血(100%)、结膜滤泡(79.1%)、眼睑水肿(39.3%)、球结膜水肿(16.1%)、假膜形成(16.6%)以及角膜上皮病变(29.9%)。在晚期随访中,13.3%的患者出现结膜上皮下纤维化,39.8%的患者出现SEI。使用2% d-PVP-I的患者中SEI发生的发生率显著降低(P=0.032;接受2% d-PVP-I和未接受的患者中分别为33.3%和45.9%)。

结论

腺病毒性角结膜炎在短期内对患者的舒适度和能力有极大影响。此外,几乎一半的患者出现与SEI相关的视力问题。根据我们的临床经验,在腺病毒性角结膜炎发病首日使用2% d-PVP-I可能有助于降低SEI作为并发症的风险。

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