Courtright P, Lewallen S, Li H Y, Hu L F, Yang J W
Department of Ophthalmology, University of British Columbia, St Paul's Hospital, Vancouver, Canada.
Lepr Rev. 1995 Sep;66(3):214-9. doi: 10.5935/0305-7518.19950023.
Lagophthalmos may be the most common potentially blinding ocular condition in leprosy. The magnitude of the problem among multibacillary patients has not been determined. We sought to ascertain the magnitude of lagophthalmos in a multibacillary leprosy patient population under multidrug therapy (MDT) (both newly diagnosed and with a prior history of dapsone monotherapy) in China and assess factors associated with its presence. In a survey of 640 multibacillary patients 3.8% of the newly diagnosed patients and 10.2% of the patients with prior dapsone monotherapy had lagophthalmos. Corneal disease and vision loss were common in both groups. Poor compliance with MDT, duration between onset and diagnosis, and duration on dapsone monotherapy were associated with the presence of lagophthalmos. Our findings suggest that there may be a threshold at which MDT must be maintained to prevent lagophthalmos. Early leprosy diagnosis and treatment would also lessen the incidence of lagophthalmos in these patients. The high proportion of lagophthalmos patients with corneal disease suggests that there has been inadequate eye care for these patients.
兔眼症可能是麻风病中最常见的潜在致盲眼部疾病。多菌型患者中该问题的严重程度尚未确定。我们试图确定中国接受多药联合化疗（MDT）的多菌型麻风病患者群体（包括新诊断患者和曾接受过单药氨苯砜治疗的患者）中兔眼症的严重程度，并评估与其存在相关的因素。在一项对640名多菌型患者的调查中，新诊断患者中有3.8%患有兔眼症，曾接受过单药氨苯砜治疗的患者中有10.2%患有兔眼症。两组患者中角膜疾病和视力丧失都很常见。MDT治疗依从性差、发病至诊断的时间以及单药氨苯砜治疗时间与兔眼症的存在有关。我们的研究结果表明，可能存在一个MDT治疗必须维持的阈值以预防兔眼症。早期麻风病诊断和治疗也将降低这些患者中兔眼症的发生率。患有角膜疾病的兔眼症患者比例较高，这表明对这些患者的眼部护理不足。
