Resnikoff S, Castan R, Peyramaure F, Bagayogo C, Huguet P
Institut d'Ophtalmologie Tropicale de l'Afrique (OCCGE), Bamako, Mali.
J Fr Ophtalmol. 1994;17(10):591-5.
In order to optimize the trachoma treatment duration, we carried out a prospective study to observe the disease course over a long period of treatment by a 1% oxytetracycline (chlorhydrate) suspension.
The study involved 50 children between 2 and 12 years living in three Malian villages. The existence of an active trachoma was clinically characterized by the presence of at least 5 follicles associated with a papillary hypertrophy of the upper tarsal conjunctiva. The treatment was administered daily 4 times a day, for two months. All patients were examined before being treated, then on the 15th, 30th and 60th day. The presence and the importance of the follicles, papillae and trachomatous scarring were scored. During treatment, no patient manifested a case of follicular score aggravation. The moderate cases reacted more rapidly than the severe ones. In most cases the reduction in the number of follicles became evident only after two weeks of treatment. On the other hand, the inflammatory hyperplasia diminished rapidly from the 15th day. The cicatricial score was constant and pre-existing scars were not aggravated. After treatment, 33 patients out of 50 (66%) could be considered cured.
The analysis of data suggests that a longer period of treatment would have led to a higher healing percentage. In fact, all forms of intense trachomatous inflammation, likely to cause blindness, diminished before the end of the control period.
为了优化沙眼治疗疗程,我们开展了一项前瞻性研究,以观察长期使用1%盐酸土霉素混悬液治疗期间的病程。
该研究纳入了居住在马里三个村庄的50名2至12岁儿童。活动性沙眼的临床特征为上睑结膜至少有5个滤泡并伴有乳头肥大。治疗为期两个月,每天给药4次。所有患者在治疗前、治疗第15天、第30天和第60天接受检查。对滤泡、乳头和沙眼瘢痕的存在情况及严重程度进行评分。治疗期间,没有患者出现滤泡评分加重的情况。中度病例比重度病例反应更快。在大多数情况下,滤泡数量的减少仅在治疗两周后才明显。另一方面,炎症性增生从第15天起迅速减轻。瘢痕评分保持不变,原有瘢痕未加重。治疗后,50名患者中有33名(66%)可被视为治愈。
数据分析表明,延长治疗时间可能会提高治愈率。事实上,所有可能导致失明的严重沙眼炎症形式在对照期结束前均有所减轻。