Limbal Stem Cell Deficiency-Demography and Underlying Causes
Limbal Stem Cell Deficiency-Demography and Underlying Causes
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DOI：
10.1016/j.ajo.2018.01.020
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发表时间：
2018-04-01
影响因子：
4.2
通讯作者：
Sangwan, Virender
中科院分区：
文献类型：
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作者：
Vazirani, Jayesh;Nair, Dhanyasree;Sangwan, Virender
目得：确定角膜缘干细胞缺乏症（LSCD）患者的人口统计学特征，并确定LSCD的根本原因。设计：回顾性，多中心病例系列。单位：两家大型三级眼科医院。受试者：方法：回顾性分析2005年1月1日至2014年12月31日在我院住院的LSCD患者的临床资料。记录就诊时的人口统计学详细信息和临床特征，以及LSCD的根本原因（如果确定）。进行描述性统计分析和图表编制。主要结果指标为LSCD的类型（单侧或双侧），患者的年龄和性别，LSCD的程度（涉及利姆布斯的时钟小时），以及LSCD的根本原因。结果：我们发现1331例LSCD患者在10年的研究期间。单侧LSCD（791例患者）比双侧LSCD（540例患者）更常见。1331例患者中，男性875例（65.74%）。患者的中位年龄为24岁。1849眼可确定LSCD的程度，其中1239眼（67.00%）为完全LSCD。1512只眼可确定LSCD的潜在病因。在单侧LSCD病例中，眼表烧伤是最常见的可识别原因（83.73%）。双侧LSCD的主要可识别原因是眼表烧伤（29.95%）、过敏性结膜炎（29.48%）、Stevens-Johnson综合征（SJS）或中毒性表皮坏死松解症（TEN）（23.11%）、无虹膜（9.43%）和粘膜类天疱疮（3.54%）。石灰（“chuna”）损伤是负责眼表烧伤的352 567例，其中代理商被确定（62.08%）。结论：在我们的研究中，单侧LSCD比双侧LSCD更常见。年轻男性受试者通常受到影响，大多数眼睛患有总LSCD。总体而言，眼表烧伤是LSCD的主要原因。单方面和双边的土地荒漠化的原因分布明显不同，需要采取不同的管理办法。(C)2018爱思唯尔公司All rights reserved.
PURPOSE: To determine the demographic features of patients affected by limbal stem cell deficiency (LSCD), and to identify the underlying causes of LSCD.DESIGN: Retrospective, multicenter case series. SETTING: Two large tertiary care ophthalmology hospitals. SUBJECTS: Patients with a diagnosis of LSCD presenting from January 1, 2005 to December 31, 2014.METHODS: Records of patients with a clinical diagnosis of LSCD were reviewed. Demographic details and clinical features at presentation, as well as the underlying cause of LSCD (if identified), were noted. Descriptive statistical analysis and chart preparation were done. Main outcome measures were type of LSCD (unilateral or bilateral), age and sex of patients, extent of LSCD (clock hours of limbus involved), and underlying cause of LSCD.RESULTS: We found 1331 patients with LSCD in the 10-year period under study. Unilateral LSCD was more common (791 patients) than bilateral LSCD (540 patients). Out of 1331 patients, 875 (65.74%) were male. The median age of patients was 24 years. Extent of LSCD could be determined in 1849 eyes, of which 1239 eyes (67.00%) had total LSCD. The underlying cause of LSCD could be identified in 1512 eyes. In cases of unilateral LSCD, ocular surface burns was the commonest identifiable cause (83.73%). The leading identifiable causes of bilateral LSCD were ocular surface burns (29.95%), allergic conjunctivitis (29.48%), Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) (23.11%), aniridia (9.43%), and mucous membrane pemphigoid (3.54%). Lime ("chuna") injury was responsible for ocular surface burns in 352 out of 567 cases in which the agent was identified (62.08%).CONCLUSIONS: In our study, unilateral LSCD was more common than bilateral LSCD. Young male subjects were commonly affected, with a majority of eyes suffering from total LSCD. Overall, ocular surface burns are the leading cause of LSCD. Unilateral and bilateral LSCD had a markedly different distribution of causes, necessitating different approaches to management. (C) 2018 Elsevier Inc. All rights reserved.