Evaluation of Medically Reversible Limbal Stem Cell Deficiency.

Q3 Medicine Turkish Journal of Ophthalmology Pub Date : 2024-10-25 DOI:10.4274/tjo.galenos.2024.69705

İlayda Korkmaz, Nihat Furkan Eratılgan, Melis Palamar, Sait Eğrilmez, Ayşe Yağcı, Özlem Barut Selver

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Abstract

Objectives: To evaluate the clinical characteristics and treatment strategies of limbal stem cell deficiency (LSCD) patients managed with medical therapy.

Materials and methods: The study included 29 eyes of 21 patients with LSCD who were managed medically at Ege University Faculty of Medicine, Department of Ophthalmology between May 2013 and May 2023. LSCD stages before and after medical treatment were recorded according to the LSCD staging system published by the International LSCD Working Group. The medical records of patients showing improvement in LSCD stage with medical treatment without surgical intervention were evaluated.

Results: The mean age was 35.5±23.8 years (range, 5-71 years) with a male-to-female ratio of 6:15. The primary etiology of LSCD was ocular rosacea in 12 patients (57.1%), marginal keratitis in the setting of blepharitis in 8 patients (38.1%), and topical medication toxicity in 1 patient (4.8%). The mean baseline best corrected visual acuity (BCVA) was 0.25±0.26 logarithm of the minimum angle of resolution (logMAR) (range, 0-1 logMAR). Pre-treatment LSCD stage was stage 1A in 5 eyes (17.2%), stage 1B in 12 eyes (41.4%), stage 1C in 4 eyes (13.8%), stage 2A in 4 eyes (13.8%), and stage 2B in 4 eyes (13.8%). Complete regression of LSCD was achieved in 6 eyes (20.7%) with medical treatment addressing the primary etiology. In the remaining eyes, after medical treatment, the severity of LSCD decreased below the surgical threshold, which is considered stage 2B. The mean final BCVA was 0.07±0.1 logMAR (range, 0-0.4 logMAR).

Conclusion: This study highlights that LSCD can be completely or partially reversible with appropriate management, especially in cases with underlying limbal niche dysfunction, where inflammation plays a significant role. Although limbal stem cell transplantation is considered the main treatment approach for LSCD, localized and early-stage LSCD can be effectively managed medically without the need for surgical intervention.

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评估医学上可逆的瓣膜干细胞缺乏症。

目的：评估采用药物治疗的角膜缘干细胞缺乏症（LSCD）患者的临床特征和治疗策略：评估接受药物治疗的角膜缘干细胞缺乏症（LSCD）患者的临床特征和治疗策略：研究对象包括2013年5月至2023年5月期间在埃格大学医学院眼科接受药物治疗的21名LSCD患者的29只眼睛。根据国际 LSCD 工作组发布的 LSCD 分期系统，记录了治疗前后的 LSCD 分期。对通过药物治疗而未进行手术干预的 LSCD 分期改善患者的病历进行了评估：平均年龄为（35.5±23.8）岁（5-71 岁），男女比例为 6:15。12名患者（57.1%）的主要病因是酒渣鼻，8名患者（38.1%）的主要病因是睑缘炎引起的边缘角膜炎，1名患者（4.8%）的主要病因是外用药物中毒。基线最佳矫正视力（BCVA）的平均值为 0.25±0.26 最小解像角的对数（logMAR）（范围为 0-1 logMAR）。治疗前 LSCD 分期为 1A 期的有 5 眼（17.2%），1B 期的有 12 眼（41.4%），1C 期的有 4 眼（13.8%），2A 期的有 4 眼（13.8%），2B 期的有 4 眼（13.8%）。有 6 只眼睛（20.7%）的 LSCD 在针对原发病因进行药物治疗后完全消退。其余眼球在接受药物治疗后，LSCD 的严重程度降至手术阈值以下，即 2B 期。最终BCVA的平均值为0.07±0.1 logMAR（范围为0-0.4 logMAR）：本研究强调，通过适当的治疗，LSCD可以完全或部分逆转，特别是在有潜在的角膜缘龛功能障碍的病例中，炎症在其中起着重要作用。虽然角膜缘干细胞移植被认为是LSCD的主要治疗方法，但局部和早期LSCD可通过药物有效控制，无需手术干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Turkish Journal of Ophthalmology Medicine-Ophthalmology

CiteScore

2.20

自引率

0.00%

发文量

期刊介绍： The Turkish Journal of Ophthalmology (TJO) is the only scientific periodical publication of the Turkish Ophthalmological Association and has been published since January 1929. In its early years, the journal was published in Turkish and French. Although there were temporary interruptions in the publication of the journal due to various challenges, the Turkish Journal of Ophthalmology has been published continually from 1971 to the present. The target audience includes specialists and physicians in training in ophthalmology in all relevant disciplines.