持续性角膜上皮缺损的发病机制和诊疗新进展
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辽宁省自然科学基金(No.2020-MS-360); 沈阳市科技项目(No.20-205-4-063)


New progress in pathogenesis and diagnosis in the treatment of persistent corneal epithelial defect
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National Science Foundation of Liaoning Province(No.2020-MS-360); Shenyang Science and Technology Bureau(No.20-205-4-063)

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    摘要:

    角膜单纯疱疹病毒感染、角膜移植术后及糖尿病患者眼内手术后,可发生持续性角膜上皮缺损(persistent corneal epithelial defect, PED)。尽管其发病率不高,但若处理不当,可引起严重后果,如继发引起角膜感染或加重、基质溃疡、穿孔、瘢痕甚至视力丧失。PED的致病原因多样,可由多种机制介导。在临床上,即使对PED进行了积极的治疗,角膜上皮仍可能难以愈合,在治疗中具有一定挑战性。目前,对于PED的治疗,标准治疗方法主要包括使用绷带镜和人工泪液,旨在为角膜上皮层提供屏障保护; 而新型治疗方法主要针对上皮再生和角膜神经重新支配; 此外,近年来还涌现了一些有潜在治疗价值的药物和方法。在这篇综述中,我们讨论了PED的流行病学、病因、诊断和治疗,重点介绍了一些新型治疗方法及研究进展。

    Abstract:

    Persistent corneal epithelial defect(PED)can occur after corneal herpes simplex virus infection, corneal transplantation, and intraocular surgery in diabetic patients. Although the incidence is not high, it can cause serious consequences if not properly managed, such as corneal infection or exacerbation, stromal ulcers, perforation, scarring, and even loss of vision. The pathogenic causes of PED are diverse and can be mediated by multiple mechanisms. In clinical practice, even with aggressive treatment, the corneal epithelium in PED eyes is difficult to heal and presents a challenge for treatment. At present, the standard treatment for PED management mainly includes the use of bandage soft contact lenses and artificial tears, aiming at the barrier protection for the corneal epithelium. The new treatment mainly focuses on epithelial regeneration and corneal nerve re-innervation. In addition, several drugs and methods with potential therapeutic value have emerged in recent years. In this review, we talk about how are the PEDs spread, what causes them, how are they diagnosed and how are they treated. We also talk about some new therapies and research process.

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林铁柱.持续性角膜上皮缺损的发病机制和诊疗新进展.国际眼科杂志, 2022,22(6):955-959.

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  • 收稿日期:2022-03-03
  • 最后修改日期:2022-04-27
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  • 在线发布日期: 2022-05-30
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