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老年患者感染性角膜炎:治疗和保视力的综述。

Infectious Keratitis in Patients Over 65: A Review on Treatment and Preserving Eyesight.

机构信息

Gavin Herbert Eye Institute, University of California, Irvine School of Medicine, Irvine, CA, USA.

Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

出版信息

Clin Interv Aging. 2024 Jul 31;19:1393-1405. doi: 10.2147/CIA.S467262. eCollection 2024.

Abstract

Infectious keratitis (IK) represents a significant global health concern, ranking as the fifth leading cause of blindness worldwide despite being largely preventable and treatable. Elderly populations are particularly susceptible due to age-related changes in immune response and corneal structure. However, research on IK in this demographic remains scarce. Age-related alterations such as increased permeability and reduced endothelial cell density further compound susceptibility to infection and hinder healing mechanisms. Additionally, inflammaging, characterized by chronic inflammation that develops with advanced age, disrupts the ocular immune balance, potentially exacerbating IK and other age-related eye diseases. Understanding these mechanisms is paramount for enhancing IK management, especially in elderly patients. This review comprehensively assesses risk factors, clinical characteristics, and management strategies for bacterial, viral, fungal, and acanthamoeba keratitis in the elderly population, offering crucial insights for effective intervention.

摘要

感染性角膜炎(IK)是一个全球性的健康问题,尽管它在很大程度上是可以预防和治疗的,但它仍是全球导致失明的第五大主要原因。老年人由于免疫反应和角膜结构随年龄的变化而变得更容易受到影响。然而,针对这一人群的 IK 研究仍然很少。与年龄相关的改变,如增加的通透性和减少的内皮细胞密度,进一步增加了感染的易感性,并阻碍了愈合机制。此外,“炎症衰老”,其特征是随着年龄的增长而发生的慢性炎症,破坏了眼部的免疫平衡,可能会使 IK 和其他与年龄相关的眼部疾病恶化。了解这些机制对于增强 IK 的管理至关重要,尤其是在老年患者中。本综述全面评估了老年人中细菌性、病毒性、真菌性和棘阿米巴性角膜炎的危险因素、临床特征和治疗策略,为有效的干预措施提供了重要的见解。

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