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急性雾状角膜上皮病变:探寻临床特征及危险因素

Acute Foggy Corneal Epithelial Disease: Seeking Clinical Features and Risk Factors.

作者信息

Li Fei, Yang Ruibo, Yang Liu, Qi Yuanyuan, Zhang Chen, Huang Yue, Zhao Shaozhen

机构信息

Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China.

出版信息

J Clin Med. 2022 Aug 30;11(17):5092. doi: 10.3390/jcm11175092.

Abstract

(1) Purpose: Here, we describe the clinical characteristics and predisposing factors of acute foggy corneal epithelial disease, a rare disease newly found during COVID-19 pandemic; (2) Methods: In this single-arm, ambispective case series study, ten patients with acute foggy corneal epithelial disease admitted between May 2020 and March 2021 were enrolled. Their detailed medical history and clinical and ophthalmic findings were recorded and analyzed; (3) Results: All the patients were female (100%), aged from 28 to 61 years (mean age of 40.4 ± 9.3 years). Seven cases (70%) had excessive eye use, and six cases (60%) had stayed up late and were overworked. Ten subjects (100%) presented with acute onset and a self-healing tendency. There was a mild-to-moderate decrease in the corrected visual acuity (0.35 ± 0.21 (LogMAR)). Slit-lamp examination showed diffuse dust-like opacity and edema in the epithelial layer of the cornea. By in vivo confocal microscope, epithelial cells presented characteristically a “relief-like” appearance. Anterior segment optical coherence tomography examination revealed that the mean epithelial thickness was increased (69.25 ± 4.31 μm, p < 0.01); (4) Conclusions: Acute foggy corneal epithelial disease is a rare disease in clinic, which tends to occur in young and middle-aged females. The typical clinical symptom is sudden foggy vision, which occurs repeatedly and can be relieved without treatment. Sex, an abnormal menstrual cycle, overuse of the eyes, fatigue and pressure might be risk factors. Changes in lifestyle and eye use habit during the COVID-19 pandemic may have possibly contributed to this disease incidence.

摘要

(1) 目的:在此,我们描述急性云雾状角膜上皮病变的临床特征和诱发因素,这是在新冠疫情期间新发现的一种罕见疾病;(2) 方法:在这项单臂、回顾性病例系列研究中,纳入了2020年5月至2021年3月期间收治的10例急性云雾状角膜上皮病变患者。记录并分析他们详细的病史以及临床和眼科检查结果;(3) 结果:所有患者均为女性(100%),年龄在28至61岁之间(平均年龄40.4±9.3岁)。7例(70%)有过度用眼情况,6例(60%)有熬夜及劳累过度情况。10例患者(100%)起病急且有自愈倾向。矫正视力有轻度至中度下降(0.35±0.21(LogMAR))。裂隙灯检查显示角膜上皮层有弥漫性尘状混浊及水肿。通过活体共聚焦显微镜检查,上皮细胞呈现出特征性的“浮雕样”外观。眼前段光学相干断层扫描检查显示平均上皮厚度增加(69.25±4.31μm,p<0.01);(4) 结论:急性云雾状角膜上皮病变在临床上是一种罕见疾病,倾向于发生在中青年女性中。典型的临床症状是突然出现云雾状视力,反复发生且未经治疗可缓解。性别、月经周期异常、过度用眼、疲劳和压力可能是危险因素。新冠疫情期间生活方式和用眼习惯的改变可能对该疾病的发病率有影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c29/9457359/ff1db6b51abe/jcm-11-05092-g001.jpg

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