Yunoki Tatsuya, Uozumi Yuto, Tojo Naoki, Otsuka Mitsuya, Hayashi Atsushi
Departments of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
Jpn J Ophthalmol. 2025 May;69(3):360-364. doi: 10.1007/s10384-025-01177-4. Epub 2025 Feb 28.
Prostaglandin-associated periorbitopathy (PAP), which causes skin hardening, ptosis, and deepening of the upper eyelid sulcus (DUES), has been suggested to affect corneal shape due to increased eyelid pressure. In this study, we performed a corneal shape analysis using anterior segment optical coherence tomography (AS-OCT) in patients with PAP accompanied by blepharoptosis.
Retrospective study.
Fourier harmonic corneal shape analysis using anterior segment OCT was performed in patients with a margin reflex distance-1 (MRD-1) of 2 mm or less (176 eyes of 101 cases). Cases with congenital ptosis, neurogenic ptosis, facial nerve palsy, thyroid eye disease, history of eyelid surgery, vitrectomy, glaucoma tube shunt surgery or filtration surgery were excluded. Patients were divided into two groups based on the presence or absence of prostaglandin analog (PGA) eye drops, and a comparative analysis was conducted.
In the comparison between the PGAs group (n=47) and the non-PGAs group (n=129), no significant differences were observed in age, gender, MRD-1, or levator function. However, the PGAs group exhibited significantly larger values for both regular and irregular astigmatism. Additionally, in the PGAs group, when the severity of PAP was classified (grades 0 to 3), there was a correlation between PAP grade and both regular and irregular astigmatism.
Patients with PAP who developed ptosis exhibited significant increases in both regular and irregular astigmatism, with a correlation observed between PAP grade and astigmatism. It is suggested that the increased eyelid pressure due to PAP may influence corneal shape.
前列腺素相关性眶周病变（PAP）可导致皮肤硬化、上睑下垂和上睑沟加深（DUES），有人认为由于眼睑压力增加，PAP会影响角膜形态。在本研究中，我们对伴有上睑下垂的PAP患者使用眼前节光学相干断层扫描（AS-OCT）进行了角膜形态分析。
回顾性研究。
对101例患者的176只眼进行了眼前节OCT的傅里叶谐波角膜形态分析，这些患者的边缘反射距离-1（MRD-1）为2mm或更小。排除先天性上睑下垂、神经源性上睑下垂、面神经麻痹、甲状腺眼病、眼睑手术史、玻璃体切除术、青光眼引流管分流手术或滤过手术的病例。根据是否使用前列腺素类似物（PGA）滴眼液将患者分为两组，并进行比较分析。
在PGA组（n=47）和非PGA组（n=129）之间的比较中，年龄、性别、MRD-1或提上睑肌功能均未观察到显著差异。然而，PGA组的规则散光和不规则散光值均显著更大。此外，在PGA组中，当对PAP的严重程度进行分级（0至3级）时，PAP分级与规则散光和不规则散光均存在相关性。
发生上睑下垂的PAP患者的规则散光和不规则散光均显著增加，且PAP分级与散光之间存在相关性。提示PAP导致的眼睑压力增加可能影响角膜形态。
