Singapore Eye Research Institute, Singapore, Singapore; National University Hospital, Singapore, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Hong Kong University, Pok Fu Lam, Hong Kong.
Surv Ophthalmol. 2023 Nov-Dec;68(6):1093-1114. doi: 10.1016/j.survophthal.2023.06.001. Epub 2023 Jun 8.
A persistent epithelial defect (PED) is a corneal epithelial defect that failed to heal after 2weeks. It is a condition that carries much morbidity, and our understanding of PED remains poor, with current treatment methods often having unsatisfactory outcomes. With PEDs becoming more prevalent, more efforts are required to establish reliable treatment modalities. Our reviews describe the causes of PEDs and the different approaches developed to manage them, as well as their associated limitations. Emphasis is placed on understanding various advances in the development of new treatment modalities. We have also described a case of a woman with a background of graft-versus-host disease on long-term topical corticosteroids who developed complicated PED involving both eyes. The current approach to managing PEDs generally involves exclusion of an active infection, followed by treatment modalities that aim to encourage corneal epithelial healing. Success rates, however, remain far from desirable, as treatment remains challenging due to multiple underlying etiologies. In summary, advances in the development of new therapies may be able to facilitate progress in the understanding and treatment of PED.
持续性上皮缺损(PED)是指角膜上皮缺损在 2 周后仍未愈合的情况。它是一种发病率很高的疾病,我们对 PED 的认识仍然很有限,目前的治疗方法往往效果不佳。随着 PED 的发病率越来越高,我们需要更多的努力来建立可靠的治疗方法。我们的综述描述了 PED 的病因以及为治疗 PED 而开发的不同方法及其相关局限性。重点放在了解新治疗方法的各种进展上。我们还描述了一位患有移植物抗宿主病并长期局部使用皮质类固醇的女性的病例,她的双眼均出现了复杂的 PED。目前治疗 PED 的方法通常包括排除活动性感染,然后采用旨在促进角膜上皮愈合的治疗方法。然而,成功率远不理想,因为由于多种潜在病因,治疗仍然具有挑战性。总之,新疗法的发展可能能够促进对 PED 的理解和治疗的进展。