Udomwech Lunla, Eden Chime, Tawanwongsri Weeratian
Department of Ophthalmology, School of Medicine, Walailak University, Nakhon Si Thammarat 80160, Thailand.
Division of Dermatology, Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Thimphu 11001, Bhutan.
Med Sci (Basel). 2025 May 16;13(2):61. doi: 10.3390/medsci13020061.
Facial melasma is a common, chronic, and relapsing hyperpigmentation disorder, affecting up to 40% of adult women in Southeast Asia. Although most cases are mild, the condition may have a considerable psychological impact. Ocular photoaging diseases are also common and have been increasingly recognized in aging populations exposed to chronic sunlight. Ultraviolet (UV) radiation is implicated in both melasma and ocular photoaging; however, their relationship remains unclear. This cross-sectional study investigated the association between facial melasma and UV-induced ocular conditions among 315 participants aged 30-80 years at Walailak University Hospital, Thailand. Facial melasma was diagnosed clinically and dermoscopically, with severity assessed using the modified Melasma Area Severity Index. Ophthalmological examinations evaluated UV-related ocular conditions, including pinguecula, pterygium, climatic droplet keratopathy, cataracts, and age-related macular degeneration. Logistic regression analyses were performed, adjusting for age, sex, and sun exposure. Facial melasma was identified in 66.0% of participants (n = 208), and nuclear cataracts were significantly associated with melasma (adjusted odds ratio, 2.590; 95% confidence interval, 1.410-4.770; = 0.002). Additionally, melasma severity correlated with nuclear cataract severity (ρ = 0.186, = 0.001). Other ocular conditions were not significantly associated with melasma. These findings suggest a shared UV-related pathogenesis between facial melasma and nuclear cataracts. Sun protection measures, including regular sunscreen use, UV-blocking eyewear, and wide-brimmed hats, may help mitigate the risk of both conditions. Further multicenter studies are warranted to confirm these findings and explore the underlying mechanisms.
面部黄褐斑是一种常见、慢性且复发性的色素沉着紊乱疾病，在东南亚影响高达40%的成年女性。尽管大多数病例为轻度，但该病症可能会产生相当大的心理影响。眼部光老化疾病也很常见，并且在长期暴露于阳光下的老年人群中越来越受到认可。紫外线（UV）辐射与黄褐斑和眼部光老化都有关联；然而，它们之间的关系仍不明确。这项横断面研究调查了泰国瓦莱拉大学医院315名年龄在30至80岁的参与者中面部黄褐斑与紫外线引起的眼部疾病之间的关联。通过临床和皮肤镜检查诊断面部黄褐斑，并使用改良的黄褐斑面积严重程度指数评估严重程度。眼科检查评估与紫外线相关的眼部疾病，包括睑裂斑、翼状胬肉、气候性滴状角膜病变、白内障和年龄相关性黄斑变性。进行了逻辑回归分析，并对年龄、性别和阳光暴露进行了调整。66.0%的参与者（n = 208）被诊断为面部黄褐斑，核性白内障与黄褐斑显著相关（调整后的优势比，2.590；95%置信区间，1.410 - 4.770；P = 0.002）。此外，黄褐斑严重程度与核性白内障严重程度相关（ρ = 0.186，P = 0.001）。其他眼部疾病与黄褐斑无显著关联。这些发现表明面部黄褐斑和核性白内障之间存在与紫外线相关的共同发病机制。防晒措施，包括定期使用防晒霜、佩戴防紫外线眼镜和宽边帽子，可能有助于降低这两种病症的风险。有必要进行进一步的多中心研究以证实这些发现并探索潜在机制。
