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与泪液排出道疾病相关的角膜病变的临床特征。

Clinical characteristics of lacrimal drainage pathway disease-associated keratopathy.

机构信息

Department of Ophthalmology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.

Department of Ophthalmology, Matsuyama Red Cross Hospital, Bunkyocho, Matsuyama, Ehime, 790-8524, Japan.

出版信息

BMC Ophthalmol. 2022 Aug 31;22(1):353. doi: 10.1186/s12886-022-02580-y.

Abstract

PURPOSE

To report the clinical characteristics of 13 cases of noninfectious corneal ulceration related to lacrimal drainage pathway disease.

METHODS

Medical records of 13 patients with lacrimal drainage pathway disease-associated keratopathy who were examined at Ehime University Hospital between April 2007 and December 2021 were analyzed.

RESULTS

The predisposing lacrimal drainage pathway diseases for corneal ulceration were chronic dacryocystitis in seven patients and lacrimal canaliculitis in six patients. The corneal ulcers were located at the peripheral cornea in 10 patients and the paracentral cornea in three patients. All patients indicated few cellular infiltrations of the ulcerated area at the slit-lamp examination. Corneal perforation was found in seven patients. The primary identified organisms were Streptococcus spp. in chronic dacryocystitis and Actinomycetes spp. in lacrimal canaliculitis. All patients showed rapid healing of the epithelial defects after treatment of the lacrimal drainage pathway disease. The mean time elapsed between treatment of the lacrimal drainage pathway disease and re-epithelialization of corneal ulcer was 14.5 ± 4.8 days.

CONCLUSION

Lacrimal drainage pathway disease-associated keratopathy may be characterized by peripheral corneal ulcer with few cellular infiltrations, occasionally leading to corneal perforation. Treatment of the lacrimal drainage pathway disease could be the most effective treatment for lacrimal drainage pathway disease-associated keratopathy.

摘要

目的

报告 13 例与泪液排出道疾病相关的非感染性角膜溃疡的临床特征。

方法

对 2007 年 4 月至 2021 年 12 月在爱媛大学医院就诊的 13 例与泪液排出道疾病相关的角膜病变患者的病历进行分析。

结果

导致角膜溃疡的潜在泪液排出道疾病为慢性泪囊炎 7 例,泪小管炎 6 例。角膜溃疡位于周边角膜 10 例,旁中央角膜 3 例。所有患者在裂隙灯检查下,溃疡区域的细胞浸润均较少。7 例患者出现角膜穿孔。在慢性泪囊炎中主要鉴定出的病原体为链球菌属,在泪小管炎中主要鉴定出的病原体为放线菌属。所有患者在治疗泪液排出道疾病后,上皮缺损均迅速愈合。治疗泪液排出道疾病与角膜溃疡上皮再形成之间的平均时间为 14.5±4.8 天。

结论

与泪液排出道疾病相关的角膜病变可能表现为周边角膜溃疡,细胞浸润较少,偶尔导致角膜穿孔。治疗泪液排出道疾病可能是治疗与泪液排出道疾病相关的角膜病变的最有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f25e/9429453/a0ca8c17023a/12886_2022_2580_Fig1_HTML.jpg

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