The Clinical Phenotype of Trachomatous Trichiasis in Ethiopia: Not All Trichiasis Is Due to Entropion
The Clinical Phenotype of Trachomatous Trichiasis in Ethiopia: Not All Trichiasis Is Due to Entropion
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DOI：
10.1167/iovs.11-7880
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发表时间：
2011-10-01
影响因子：
4.4
通讯作者：
Burton, Matthew J.
中科院分区：
文献类型：
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作者：
Rajak, Saul N.;Habtamu, Esmael;Burton, Matthew J.
目的。沙眼性倒睫 (TT) 通常被描述为上眼睑的疤痕性内翻；然而，也有其他形式的倒睫的报道。临床表型的这种变化对于治疗指南可能很重要。因此，本研究旨在调查 TT.METHODS 涵盖的疾病类型和严重程度范围。接受 TT 手术治疗的个体由一名眼科医生使用详细的世界卫生组织沙眼分级系统进行检查。对其他特征进行分级，包括倒睫睫毛的类型（化生、误导和熵变）、下眼睑倒睫、睑内翻严重程度和眼睑边缘粘膜皮肤交界处 (MCJ) 位置。 结果。招募了 2556 名至少一只眼睛以前未接受过 TT 手术的个体（4310 只眼睛）。接触眼睛的睫毛数量中位数为 2（范围，0 [脱毛]-133）。 2328只眼（54.0%）无内翻或轻度内翻，1259只眼（29.2%）中度内翻，723只眼（16.8%）重度内翻。倒睫睫毛主要是化生或方向错误（80.2%），而不是继发于睑内翻； 4204 名 (97.7%) 的 MCJ 位于前位； 494 例（11.5%）存在下眼睑倒睫。 BMI低、女性、年龄小于50岁、中度至重度结膜炎症、中央角膜混浊和严重结膜疤痕的患者眼睑内翻更为严重。结论。许多 TT 患者的眼睑内翻很少或没有。倒睫通常归因于睫毛化生或方向错误。应调查无明显睑内翻的 TT 患者的跗骨旋转手术结果，并评估潜在的替代治疗策略。 （投资眼科可见科学。2011；52：7974-7980）DOI：10.1167/iovs.11-7880
PURPOSE. Trachomatous trichiasis (TT) is usually described as a cicatricial entropion of the upper lid; however, other forms of trichiasis have been reported. This variation in clinical phenotype is potentially important for treatment guidelines. Therefore, this study was conducted to investigate the range of disease type and severity encompassed by TT.METHODS. Individuals presenting with TT to surgical treatment campaigns were examined by a single ophthalmologist using the Detailed WHO Trachoma Grading System. Additional features were graded, including type of trichiatic lashes (metaplastic, misdirected, and entropic), lower lid trichiasis, entropion severity, and lid margin mucocutaneous junction (MCJ) position.RESULTS. Recruited were 2556 individuals with previously unoperated TT in at least one eye (4310 eyes). The median number of lashes touching the eye was 2 (range, 0 [epilating]-133). Entropion was absent or mild in 2328 (54.0%) eyes, moderate in 1259 (29.2%) eyes, and severe in 723 (16.8%) eyes. Trichiatic lashes were predominantly metaplastic or misdirected (80.2%), rather than secondary to entropion; 4204 (97.7%) had anteroplacement of the MCJ; and lower lid trichiasis was present in 494 (11.5%). Entropion was more severe among those with a low BMI, those who were female, those aged less than 50 years, and those with moderate to severe conjunctival inflammation, central corneal opacity, and severe conjunctival scarring.CONCLUSIONS. Many patients with TT have minimal or no entropion. The trichiasis is frequently attributable to metaplastic or misdirected eyelashes. The results of tarsal rotation surgery in TT patients without manifest entropion should be investigated and potentially alternative treatment strategies evaluated. (Invest Ophthalmol Vis Sci. 2011;52:7974-7980) DOI:10.1167/iovs.11-7880