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0.66%纳米乳剂聚维酮碘治疗角膜溃疡:一例报告

Corneal Ulcer Treated with 0.66% Nanoemulsion Povidone-Iodine: A Case Report.

作者信息

Bordin Paolo

机构信息

Department of Ophthalmology, Legnago Hospital, Legnago, Verona, Italy.

出版信息

Am J Case Rep. 2020 Jan 24;21:e919822. doi: 10.12659/AJCR.919822.

Abstract

BACKGROUND Corneal ulceration is caused by various corneal diseases, including infection, inflammatory disease, neurotrophic keratitis, dry-eye, autoimmune disease, and blepharitis. Treatment should be based on the etiology. In cases of infection, corneal scraping and pathogen culture should be carried out before treatment. Bacterial pathogens are the most common etiology, but it can be caused also by viruses, fungi, and protozoa. Quinolones are the first-line drug for bacterial keratitis, but the treatment should be changed according to the culture and drug sensitivity test results. The purpose of this case report is to show the resolution of a corneal ulcer case unusually treated with 0.66% povidone-iodine (PVP-I). CASE REPORT A 61-year-old man showed signs of pain, redness, watering, and photophobia in the left eye (oculus sinister; OS) over a 5-month period, starting as conjunctivitis and degenerating into keratitis. Clinical examination revealed an ulcer in the inferior cornea and biomicroscopy analysis confirmed this diagnosis. Previous therapies, starting with antibiotics first and then antiviral medications, were unable to control the signs and symptoms. Therefore, treatment with 0.66% PVP-I, based on its antiseptic activity, was administered 3 times a day for 4 weeks. CONCLUSIONS PVP-I 0.66%, an antiseptic with broad-spectrum activity against bacteria, fungi, viruses, and protozoa, was found to be effective in treating the signs and symptoms of the ulcer until its complete closure and resolution. It could be a useful therapeutic tool when the pathogen is unknown, as in this case. Its use for treatment of corneal ulcers warrants further investigation.

摘要

背景

角膜溃疡由多种角膜疾病引起,包括感染、炎症性疾病、神经营养性角膜炎、干眼症、自身免疫性疾病和睑缘炎。治疗应基于病因。对于感染病例,治疗前应进行角膜刮片和病原体培养。细菌病原体是最常见的病因,但也可能由病毒、真菌和原生动物引起。喹诺酮类药物是细菌性角膜炎的一线用药,但应根据培养和药敏试验结果调整治疗方案。本病例报告的目的是展示一例用0.66%聚维酮碘(PVP-I)异常治疗的角膜溃疡病例的治愈情况。病例报告:一名61岁男性在5个月内左眼出现疼痛、发红、流泪和畏光症状,最初为结膜炎,后来恶化为角膜炎。临床检查发现下角膜有溃疡,生物显微镜分析证实了这一诊断。先前的治疗先使用抗生素,然后使用抗病毒药物,均无法控制症状。因此,基于其抗菌活性,给予0.66% PVP-I治疗,每天3次,持续4周。结论:0.66% PVP-I是一种对细菌、真菌、病毒和原生动物具有广谱活性的防腐剂,在溃疡完全闭合和治愈前,被发现对治疗溃疡的症状有效。在病原体不明的情况下,如本病例,它可能是一种有用的治疗工具。其用于治疗角膜溃疡值得进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb12/6998789/b62a3c998154/amjcaserep-21-e919822-g001.jpg

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