Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences; Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China.
Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Graefes Arch Clin Exp Ophthalmol. 2020 May;258(5):1081-1086. doi: 10.1007/s00417-020-04622-x. Epub 2020 Feb 15.
The purpose of the study is to analyze the incidence, manifestations, and treatment of blepharoptosis caused by long-term use of corticosteroid eyedrops.
Retrospective case series include 46 patients with a history of using corticosteroid eyedrops unilaterally for at least 2 months. The palpebral fissure, MRD1, and levator function were evaluated.
Among 46 patients, the differences of mean MRD1 (p < 0.0005), palpebral fissure height (p < 0.0005), and levator function (p = 0.003) between eyes with and without corticosteroid eyedrops application were significant. Ptosis existed in 40 out of 46 eyes with corticosteroid; the differences of the mean MRD1 (p < 0.0005) and palpebral fissure height (p = 0.001) between eyes with and without ptosis were significant. Nine patients underwent levator aponeurosis repair surgeries. Pathological examinations revealed mainly vascular fibers and few muscle fibers, as well as apoptosis of levator palpebrae muscle and Muller muscle.
Blepharoptosis is frequently observed after chronic corticosteroid eyedrops use in Chinese population.
本研究旨在分析长期使用皮质类固醇滴眼剂引起的上睑下垂的发病率、表现和治疗方法。
回顾性病例系列研究纳入了 46 例单侧使用皮质类固醇滴眼剂至少 2 个月的患者。评估了睑裂、MRD1 和提上睑肌功能。
在 46 例患者中，应用皮质类固醇滴眼剂眼与未应用眼的平均 MRD1（p<0.0005）、睑裂高度（p<0.0005）和提上睑肌功能（p=0.003）差异均有统计学意义。46 只眼中有 40 只出现皮质类固醇性上睑下垂；有和无上睑下垂眼的平均 MRD1（p<0.0005）和睑裂高度（p=0.001）差异均有统计学意义。9 例患者接受了提上睑肌腱膜修复手术。病理检查主要显示血管纤维，少量肌肉纤维，以及提上睑肌和 Muller 肌的凋亡。
在中国人群中，慢性皮质类固醇滴眼剂使用后常发生上睑下垂。
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