Guo F, Liang Q F
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing 100730, China.
Zhonghua Yan Ke Za Zhi. 2024 Oct 11;60(10):854-859. doi: 10.3760/cma.j.issn.0412-4081-20240329-00149.
Microsporidia, a unicellular eukaryotic microorganism, poses a risk of infecting the eyes, precipitating microsporidia keratitis (MK). This condition typically manifests in two forms: microsporidian keratoconjunctivitis (MKC) or stromal keratitis (MSK). While MKC often resolves spontaneously, it can progress to MSK, a vision-threatening condition that, in severe instances, may lead to corneal perforation. Epidemiological studies reveal that MK is prevalent in Southeast Asia, particularly during the rainy season. Diagnosis encompasses a range of methods, including corneal scraping for microbiological analysis, PCR testing, and advanced imaging techniques such as AS-OCT and IVCM. Therapeutic approaches vary, with MKC typically managed through local and systemic drug therapy, while MSK may necessitate more aggressive interventions, including corneal transplantation. In China, MK case reports are scarce, and physicians still grapple with a lack of comprehensive understanding regarding its clinical presentation, diagnostic strategies, and treatment options. This deficit can lead to missed or misdiagnoses, as well as overtreatment. Consequently, this review endeavors to comprehensively outline the epidemiology, etiology, clinical features, diagnostic modalities, and therapeutic interventions for MK, thereby offering valuable insights and guidance for clinical practice.
微孢子虫是一种单细胞真核微生物,有感染眼睛的风险,可引发微孢子虫角膜炎(MK)。这种病症通常有两种表现形式:微孢子虫角膜结膜炎(MKC)或基质性角膜炎(MSK)。虽然MKC通常可自行缓解,但可能会发展为MSK,这是一种威胁视力的病症,在严重情况下可能导致角膜穿孔。流行病学研究表明,MK在东南亚很普遍,尤其是在雨季。诊断方法包括多种,如进行角膜刮片以作微生物分析、PCR检测以及使用AS-OCT和IVCM等先进成像技术。治疗方法各不相同,MKC通常通过局部和全身药物治疗来处理,而MSK可能需要更积极的干预措施,包括角膜移植。在中国,MK的病例报告很少,医生对其临床表现、诊断策略和治疗选择仍缺乏全面了解。这种不足可能导致漏诊或误诊,以及过度治疗。因此,本综述旨在全面概述MK的流行病学、病因、临床特征、诊断方式和治疗干预措施,从而为临床实践提供有价值的见解和指导。