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亚洲春季角结膜炎的诊断、管理与治疗:亚洲春季角结膜炎管理专家工作组的建议

Diagnosis, Management, and Treatment of Vernal Keratoconjunctivitis in Asia: Recommendations From the Management of Vernal Keratoconjunctivitis in Asia Expert Working Group.

作者信息

Mehta Jodhbir S, Chen Wei-Li, Cheng Arthur C K, Cung Le Xuan, Dualan Ivo J, Kekunnaya Ramesh, Khaliddin Nurliza, Kim Tae-Im, Lam Douglas K, Leo Seo Wei, Manurung Florence, Tesavibul Nattaporn, Bremond-Gignac Dominique

机构信息

Corneal & External Eye Disease Department, Singapore National Eye Centre, Singapore, Singapore.

Department of Ophthalmology and Advanced Ocular Surface and Corneal Nerve Research Center, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

Front Med (Lausanne). 2022 Aug 1;9:882240. doi: 10.3389/fmed.2022.882240. eCollection 2022.

Abstract

Vernal keratoconjunctivitis (VKC) is an underdiagnosed and underrecognized ocular surface disease with limited epidemiological data in Asia. It is more prevalent in warm, dry, and windy climates, and often has a substantial impact on a patient's quality of life. In rare cases, VKC can be associated with vision loss, either through corticosteroid overuse or inadequate treatment of persistent inflammation. As a potentially severe and complex disease, there is variability with how VKC is managed across Asia and among the various allergic eye diseases. Diagnosis and treatment of patients with VKC is a challenge for many ophthalmologists, since no precise diagnostic criteria have been established, the pathogenesis of the disease is unclear, and anti-allergic treatments are often ineffective in patients with moderate or severe disease. In addition, the choice of treatment and management strategies used for patients varies greatly from country to country and physician to physician. This may be because of a lack of well-defined, standardized guidelines. In response, the Management of Vernal Keratoconjunctivitis in Asia (MOVIA) Expert Working Group (13 experts) completed a consensus program to evaluate, review, and develop best-practice recommendations for the assessment, diagnosis, and management of VKC in Asia. The expert-led recommendations are summarized in this article and based on the currently available evidence alongside the clinical expertise of ophthalmologists from across Asia with specialism and interest in the ocular surface, VKC, and pediatric ophthalmology.

摘要

春季角结膜炎(VKC)是一种在亚洲诊断不足且认识不足的眼表疾病,流行病学数据有限。它在温暖、干燥和多风的气候中更为普遍,并且常常对患者的生活质量产生重大影响。在极少数情况下,VKC可因皮质类固醇过度使用或持续性炎症治疗不充分而导致视力丧失。作为一种潜在的严重且复杂的疾病,亚洲各地以及各种变应性眼病中VKC的管理方式存在差异。对于许多眼科医生而言,VKC患者的诊断和治疗是一项挑战,因为尚未建立精确的诊断标准,疾病的发病机制尚不清楚,并且抗过敏治疗对中度或重度患者往往无效。此外,针对患者使用的治疗和管理策略的选择在不同国家和不同医生之间差异很大。这可能是由于缺乏明确、标准化的指南。对此,亚洲春季角结膜炎管理(MOVIA)专家工作组(13名专家)完成了一项共识计划,以评估、审查并制定亚洲VKC评估、诊断和管理的最佳实践建议。本文总结了专家主导的建议,这些建议基于目前可得的证据以及来自亚洲各地、在眼表、VKC和小儿眼科领域具有专业知识和兴趣的眼科医生的临床专业知识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd84/9376221/777eda1bbf39/fmed-09-882240-g001.jpg

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