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睑板腺炎相关性角结膜炎所致角膜上皮病变的特征及治疗效果

The Features and Treatment Effects on Keratoepitheliopathy for Meibomitis-Related Keratoconjunctivitis.

作者信息

Sonomura Yukiko, Yokoi Norihiko, Komuro Aoi, Kato Hiroaki, Sotozono Chie

机构信息

Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.

出版信息

Diagnostics (Basel). 2024 Feb 23;14(5):487. doi: 10.3390/diagnostics14050487.

Abstract

Meibomitis-related keratoconjunctivitis (MRKC) is characterized by meibomitis with corneal epithelial abnormalities, and can be divided into two types: MRKC accompanied with phlyctenular keratitis, and MRKC accompanied with keratoepitheliopathy that is similar to superficial punctate keratopathy (SPK). The purpose of this retrospective study was to investigate the characteristic features of keratoepitheliopathy and treatment outcomes for MRKC. This study involved 27 eyes of 18 MRKC patients (3 males and 15 females). National Eye Institute (NEI) scores and visual acuity were compared at pre and post treatment. All subjects were treated with a small-dose administration of clarithromycin. Keratoepitheliopathy characteristic to MRKC, yet different in appearance from SPK, was noted in 24 of the 27 eyes. Fluorescein staining revealed granular epithelial lesions generally larger than SPK that coexisted with small dark spots. In 17 eyes, keratoepitheliopathy was located within the pupillary zone, and the visual acuity in 12 eyes was less than 1.0. Our findings showed significant improvement in the NEI score in MRKC ( < 0.0001) and in visual acuity ( = 0.0157) post treatment, and the characteristic features of keratoepitheliopathy in MRKC that are often associated with decreased visual acuity were elucidated. The treatment of clarithromycin was found to be effective for MRKC with keratoepitheliopathy.

摘要

睑板腺炎相关性角结膜炎(MRKC)的特征为伴有角膜上皮异常的睑板腺炎,可分为两种类型:伴有泡性角膜炎的MRKC和伴有类似于浅层点状角膜炎(SPK)的角膜上皮病变的MRKC。这项回顾性研究的目的是调查MRKC角膜上皮病变的特征及治疗效果。本研究纳入了18例MRKC患者的27只眼(男性3例,女性15例)。比较治疗前后的美国国立眼科研究所(NEI)评分和视力。所有受试者均接受小剂量克拉霉素治疗。在27只眼中的24只眼中发现了MRKC特有的角膜上皮病变,但其外观与SPK不同。荧光素染色显示颗粒状上皮病变通常比SPK大,且与小的黑点共存。17只眼中,角膜上皮病变位于瞳孔区内,12只眼的视力低于1.0。我们的研究结果显示,治疗后MRKC的NEI评分(<0.0001)和视力(=0.0157)有显著改善,并阐明了MRKC中常与视力下降相关的角膜上皮病变的特征。发现克拉霉素治疗对伴有角膜上皮病变的MRKC有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89cb/10930652/50ecbd05aa89/diagnostics-14-00487-g001a.jpg

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