Department of Ophthalmology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.
Department of Ophthalmology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.
An Bras Dermatol. 2024 Jul-Aug;99(4):513-519. doi: 10.1016/j.abd.2023.07.005. Epub 2024 Apr 12.
To evaluate the effects of rosacea on ocular surface changes such as alterations in dry eye parameters, corneal densitometry, and aberrations, in comparison with healthy controls.
A total of 88 eyes of 44 patients diagnosed with rosacea and 88 eyes of 44 healthy controls were enrolled in this cross-sectional study. All participants underwent a comprehensive dermatologic and ophthalmic examination and Tear Break-Up Time (TBUT) and Schirmer-1 tests were performed. The rosacea subtype and Demodex count and OSDI scores of all participants were recorded. Corneal topographic, densitometric, and aberrometric measurements were obtained using the Scheimpflug imaging system.
The mean age of the 44 patients was 41.2 ± 11.0 years of whom 31 (70.5%) were female. The mean TBUT and Schirmer-1 test values were significantly decreased and OSDI scores were significantly increased in the rosacea group compared to healthy controls (p < 0.01 for all). The most common subtype of rosacea was erythematotelangiectatic rosacea (70.4%). The severity grading of rosacea revealed that 18 (40.9%) patients had moderate erythema. The median (min-max) Demodex count was 14.0 (0-120) and the disease duration was 24.0 (5-360) months. The comparison of the corneal densitometry values revealed that the densitometry measurements in all concentric zones, especially in central and posterior zones were higher in rosacea patients. Corneal aberrometric values in the posterior surface were also lower in the rosacea group compared to healthy controls. The topographic anterior chamber values were significantly lower in the rosacea group.
Relatively small sample size, variable time interval to hospital admission, and lack of follow-up data are among the limitations of the study. Future studies with larger sample sizes may also enlighten the mechanisms of controversial anterior segment findings by evaluating rosacea patients who have uveitis and those who do not.
Given the fact that ocular signs may precede cutaneous disease, rosacea is frequently underrecognized by ophthalmologists. Therefore, a comprehensive examination of the ocular surface and assessment of the anterior segment is essential. The main priority of the ophthalmologist is to treat meibomian gland dysfunction and Demodex infection to prevent undesired ocular outcomes.
评估酒渣鼻对眼部表面变化的影响，如干眼症参数、角膜密度和像差的变化，并与健康对照组进行比较。
本横断面研究共纳入 44 例酒渣鼻患者的 88 只眼和 44 例健康对照者的 88 只眼。所有参与者均接受全面的皮肤科和眼科检查，并进行泪膜破裂时间（Tear Break-Up Time，TBUT）和 Schirmer 试验。记录所有参与者的酒渣鼻亚型和蠕形螨计数及 Ocular Surface Disease Index（OSDI）评分。使用 Scheimpflug 成像系统获得角膜地形、密度和像差测量值。
44 例患者的平均年龄为 41.2±11.0 岁，其中 31 例（70.5%）为女性。与健康对照组相比，酒渣鼻组的平均 TBUT 和 Schirmer 试验值显著降低，OSDI 评分显著升高（均 p<0.01）。酒渣鼻最常见的亚型是红斑毛细血管扩张型酒渣鼻（erythematotelangiectatic rosacea，70.4%）。酒渣鼻的严重程度分级显示，18 例（40.9%）患者有中度红斑。中位（最小-最大）蠕形螨计数为 14.0（0-120），疾病持续时间为 24.0（5-360）个月。角膜密度值的比较显示，酒渣鼻患者各同心区，尤其是中央和后区的密度测量值较高。与健康对照组相比，酒渣鼻组后表面的角膜像差值也较低。与健康对照组相比，酒渣鼻组前房的地形值显著降低。
本研究的局限性包括样本量相对较小、入院时间间隔变化以及缺乏随访数据。未来更大样本量的研究也可能通过评估患有葡萄膜炎和不患有葡萄膜炎的酒渣鼻患者，阐明有争议的前节发现的机制。
鉴于眼部表现可能先于皮肤疾病，酒渣鼻常被眼科医生漏诊。因此，全面检查眼部表面并评估前节至关重要。眼科医生的主要重点是治疗睑板腺功能障碍和蠕形螨感染，以防止出现不良的眼部结局。
