Lee Yhu Fhei, Yong Dayna Wei Wei, Manotosh Ray
Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.
Department of Ophthalmology, National University Hospital, Singapore 119074, Singapore.
Biology (Basel). 2023 Dec 5;12(12):1490. doi: 10.3390/biology12121490.
Limbal stem cell deficiency (LSCD) is a pathologic condition caused by the dysfunction and destruction of stem cells, stem cell precursors and limbal cell niche in the corneal epithelium, leading to severe conjunctivalization of the cornea. Etiologies for LSCD span from congenital (aniridia), traumatic (chemical or thermal injuries), autoimmune (Stevens-Johnson syndrome) and iatrogenic disease to contact lens (CL) wear. Of these, CL wear is the least understood and is often a subclinical cause of LSCD. Even with recent advances in LSCD research, limitations persist in establishing the pathogenesis and treatment guidelines for CL-induced LSCD. A literature search was conducted to include original articles containing patients with CL-induced LSCD. This review will critically discuss the complex pathophysiology behind CL-induced LSCD, the underlying risk factors and epidemiology of the disease as well as methods to obtain a diagnosis. Various treatment options will be reviewed based on proposed treatment strategies.
角膜缘干细胞缺乏症(LSCD)是一种由角膜上皮中的干细胞、干细胞前体和角膜缘细胞微环境功能障碍及破坏引起的病理状况,会导致角膜严重结膜化。LSCD的病因包括先天性(无虹膜)、创伤性(化学或热损伤)、自身免疫性(史蒂文斯-约翰逊综合征)和医源性疾病以及佩戴隐形眼镜(CL)。其中,佩戴CL引发LSCD的情况了解最少,且往往是LSCD的亚临床病因。即便LSCD研究最近取得了进展,但在确立CL诱发的LSCD的发病机制和治疗指南方面仍存在局限性。我们进行了文献检索,纳入了包含CL诱发LSCD患者的原始文章。本综述将批判性地讨论CL诱发LSCD背后的复杂病理生理学、该疾病的潜在危险因素和流行病学以及诊断方法。将根据提议的治疗策略对各种治疗选择进行综述。