基于 Bonini 分级临床严重程度的改良治疗方案治疗春季角结膜炎的疗效。
Effectiveness of a modified therapeutic protocol for the management of vernal keratoconjunctivitis based on Bonini's graded clinical severity.
机构信息
Consultant, Department of Ophthalmology, Kar Vision Eye Hospital, Bhubaneswar, Odisha, India.
Senior Consultant, Department of Ophthalmology, RGH Rourkela, Odisha, India.
出版信息
Indian J Ophthalmol. 2022 Jul;70(7):2408-2414. doi: 10.4103/ijo.IJO_3190_21.
PURPOSE
To evaluate the effectiveness of a modified therapeutic protocol used for vernal keratoconjunctivitis (VKC) based on severity as per Bonini grading system.
METHODS
This was a prospective observational clinical study conducted with 123 eyes of 63 patients. A meticulous clinical examination was performed, and data was documented in all the cases. Patients on known systemic atopy and antiallergic therapy were excluded from the study. Eyes with a clinical diagnosis of VKC were segregated based on Bonnini's grading system. A treatment protocol was created depending on the grade of VKC. Therapeutic responses were documented at 3 weeks, 3 months, 6 months, 12 months, and 24 months. Grading of the eyes was performed in each visit.
RESULTS
The mean age of the patients was 8.85 years with a standard deviation of 4.48 years. Males were predominant, and 95.24% had bilateral manifestation. The palpebral component was the most common form of manifestation. Itching was the most common manifestation, followed by congestion, discharge, and papillae in a decreasing order. Also, 68% of patients were in grade 2, 14% in grade 3, 12% in grade 1, and the rest were in grade 4. Following the treatment protocol, 70% showed signs of significant improvement in grade by the end of 6 weeks, reaching 90% at the end of 6 months (P = 0.074) and 92% at the end of 12 months (P = 0.002). Also, 52.4% versus 77.8% of patients had no recurrence in the pre- versus posttreatment protocol and it was statistically significant (P = 0.001).
CONCLUSION
Grading of VKC gives a clear evaluation of the severity and progression of the condition. Besides, significant improvement in the grades was observed with fewer incidences of recurrences following execution of the therapeutic protocol. Hence, it is essential to maintain a treatment protocol in our clinical practice to provide grade-based therapy and monitor accurate changes in the clinical condition.
目的
根据 Bonini 分级系统评估基于严重程度的改良治疗方案治疗春季角结膜炎（VKC）的有效性。
方法
这是一项前瞻性观察性临床研究，共纳入 63 例患者的 123 只眼。对所有病例进行了详细的临床检查，并记录了数据。已知患有系统性过敏和抗过敏治疗的患者被排除在研究之外。根据 Bonnini 分级系统，将临床诊断为 VKC 的眼睛进行分组。根据 VKC 的严重程度制定治疗方案。在 3 周、3 个月、6 个月、12 个月和 24 个月时记录治疗反应。每次就诊时都对眼睛进行分级。
结果
患者的平均年龄为 8.85 岁，标准差为 4.48 岁。男性居多，95.24%为双眼发病。最常见的表现形式是睑板腺受累。瘙痒是最常见的症状，其次是充血、分泌物和乳头，依次减少。此外，68%的患者为 2 级，14%为 3 级，12%为 1 级，其余为 4 级。根据治疗方案，70%的患者在 6 周结束时表现出明显的分级改善迹象，在 6 个月结束时达到 90%（P = 0.074），在 12 个月结束时达到 92%（P = 0.002）。此外，治疗前后方案中分别有 52.4%和 77.8%的患者无复发，差异具有统计学意义（P = 0.001）。
结论
VKC 分级可清晰评估疾病的严重程度和进展。此外，执行治疗方案后，观察到分级显著改善，复发率降低。因此，在临床实践中保持治疗方案非常重要，以便根据分级提供治疗，并监测临床状况的准确变化。
Zotero 插件