Ocular Surface最新文献_第3页

A systematic review assessing the quality of patient reported outcome measures in ocular surface disease 一项评估眼表疾病患者报告结果测量质量的系统综述。

IF 5.9 1区医学 Q1 OPHTHALMOLOGY

Ocular Surface

Pub Date : 2025-01-01 DOI: 10.1016/j.jtos.2024.11.011

Pawan Baral, Sheela Kumaran, Fiona Stapleton, Konrad Pesudovs

Objective

To identify and assess the quality of currently available validated patient reported outcome measures (PROMs) used to measure the quality of life (QoL) impacts of ocular surface diseases (OSDs).

Methods

A literature search was performed in the PubMed, Embase, Scopus, Cochrane Library, and Web of Science databases. Articles reporting on the development, validation, and use of PROMs specific to ocular surface diseases were included for review. The studies were classified based on the target population for which they were developed. Data on content identification, selection, psychometric properties, validity, and reliability were extracted. These data were assessed using the established quality assessment criteria for ophthalmic PROMs. A review of the contents of the PROMs was also performed.

Results

We identified 67 studies that met the inclusion criteria. These studies used 34 unique PROMs including 16 dry eye specific PROMs, 4 contact lens specific PROMs, 1 meibomian gland dysfunction specific PROM, 1 blepharitis specific PROM, 5 Sjögren Syndrome specific PROMs, 4 generic PROMs, 1 computer vision specific PROM, 1 ocular pain specific PROM and 1 bone marrow transplant specific PROM used in ocular graft versus host disease. Testing of psychometric properties for validation was uncommon. Most of the reported data were limited to internal consistency, convergent, and known group validity. The majority (25 out of 34) of the PROMs did not involve patients for content development. Twenty-four PROMs measured symptoms only and the remaining 9 PROMs had items from other QoL domains.

Conclusion

This review provides a current evaluation of extant PROMs for OSD. The assessment of PROMs displayed some strengths but highlighted numerous limitations. Not involving patients for the development of PROM, limited content, inadequately reported or poor psychometric properties, and issues with multidimensionality were the main limitations. Based on this we cannot recommend a single best PROM for measuring OSD-specific QoL. This review underscores the need for the development of a higher quality PROM and suggest directions for future research.

目的：确定和评估目前可用的经过验证的患者报告结果测量（PROMs）的质量，用于测量眼表疾病（OSDs）对生活质量（QoL）的影响。方法：在PubMed、Embase、Scopus、Cochrane Library和Web of Science数据库中进行文献检索。本文纳入了有关眼表疾病特异性PROMs的开发、验证和使用的文章进行综述。这些研究是根据所针对的目标人群进行分类的。提取了内容识别、选择、心理测量特性、效度和信度方面的数据。采用已建立的眼科PROMs质量评价标准对这些数据进行评价。此外，我们亦检讨了有关文件的内容。结果：我们确定了67项符合纳入标准的研究。这些研究使用了34种独特的PROM，包括16种干眼特异性PROM， 4种隐形眼镜特异性PROM， 1种睑板腺功能障碍特异性PROM， 1种眼炎特异性PROM， 5种Sjögren综合征特异性PROM， 4种通用PROM， 1种计算机视觉特异性PROM， 1种眼痛特异性PROM和1种骨髓移植特异性PROM，用于眼移植物抗宿主病。为验证而进行的心理测量特性测试并不常见。大多数报告的数据仅限于内部一致性、收敛性和已知组效度。大多数（34个中的25个）PROMs不涉及患者进行内容开发。24个prom仅测量症状，其余9个prom包含来自其他QoL域的项目。结论：本文综述了现有的用于OSD的prom的现状。对prom的评估显示了一些优势，但也强调了许多局限性。未涉及患者进行早膜损伤的研究，内容有限，不充分的报告或较差的心理测量特性，以及多维度问题是主要的局限性。基于此，我们不能推荐一个最佳的PROM来测量osd特定的QoL。这篇综述强调了开发高质量PROM的必要性，并提出了未来研究的方向。

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引用次数: 0

Biology and medicine on ocular surface restoration: Advancements and limits of limbal stem cell deficiency treatments 眼表修复的生物学与医学：角膜缘干细胞缺失治疗的进展与局限。

IF 5.9 1区医学 Q1 OPHTHALMOLOGY

Ocular Surface

Pub Date : 2025-01-01 DOI: 10.1016/j.jtos.2024.11.005

Vincenzo Giuseppe Genna , Eleonora Maurizi , Paolo Rama , Graziella Pellegrini

Ocular vision can be hampered by corneal damages, sensibly reducing patients' quality of life and having important social and economic consequences. Ocular surface diseases, which often lead to corneal opacities with visual impairment are the most severe forms of the Limbal Stem Cell Deficiency (LSCD). The present review provides an updated perspective on the available treatments for LSCD, focusing on clinical and biological features, as well as critical points to monitor during clinical translation. Recently developed surgical treatments for LSCD are described, along with their benefits and limitations, with the aim of addressing the issue of correct patient selection.

Autologous surgical approaches have been attempted, such as conjunctival limbal autograft (CLAU), simple limbal epithelial transplantation (SLET), and others. Allogeneic limbal stem cell transplantation represents an alternative but carries risk of rejection and requires immunosuppression. Other potential treatments are based on induced pluripotent stem cells (iPSCs), but they require further investigation. The development of advanced therapy medicinal products (ATMPs) such as cultivated limbal epithelial transplantation (CLET), or the use of other epithelia as cultivated oral mucosal epithelial cell transplantation (COMET), has opened additional therapeutic possibilities. Some common critical issues in clinical translation are described, such as patient selection, biopsy procurement, or the use of human/animal derived components, which require rigorous validation to ensure safety and efficacy. Personalized medicine is a promising field for ocular surface restoration, where long-term follow-up studies and standardized criteria are crucial to evaluate the efficacy of these treatments and their cost-effectiveness in providing high-value healthcare.

角膜损伤会影响视力，明显降低患者的生活质量，并对社会和经济产生重要影响。眼表疾病通常会导致角膜混浊并伴有视力障碍，是角膜缘干细胞缺乏症（LSCD）最严重的形式。本综述提供了现有 LSCD 治疗方法的最新视角，重点关注临床和生物学特征，以及临床转化过程中需要监测的关键点。本文介绍了最近开发的 LSCD 手术疗法及其优点和局限性，旨在解决正确选择患者的问题。目前已尝试的自体手术方法包括结膜瓣自体移植（CLAU）、单纯瓣上皮移植（SLET）等。异体睑缘干细胞移植是一种替代方法，但存在排斥风险，而且需要免疫抑制。其他潜在的治疗方法以诱导多能干细胞（iPSCs）为基础，但还需要进一步研究。先进治疗药物产品（ATMP）的开发，如培养的睑缘上皮细胞移植（CLET），或使用其他上皮细胞，如培养的口腔粘膜上皮细胞移植（COMET），为治疗提供了更多可能性。本文介绍了临床转化过程中一些常见的关键问题，如患者选择、活检采集或人/动物衍生成分的使用，这些都需要严格的验证以确保安全性和有效性。个性化医疗是眼表修复的一个前景广阔的领域，长期跟踪研究和标准化标准对于评估这些治疗方法的疗效及其在提供高价值医疗保健方面的成本效益至关重要。

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引用次数: 0

Impact of particulate matter and air pollution on ocular surface disease: A systematic review of preclinical and clinical evidence 颗粒物和空气污染对眼表疾病的影响：临床前和临床证据的系统回顾。

IF 5.9 1区医学 Q1 OPHTHALMOLOGY

Ocular Surface

Pub Date : 2025-01-01 DOI: 10.1016/j.jtos.2024.12.003

Sana Iqbal , Abhishek Ramini , Simon Kaja

Purpose

Exposure to particulate matter (PM) and air pollution has been implicated in the etiology of ocular surface diseases (OSD). The purpose of this systematic review is to evaluate and synthesize peer-reviewed literature on the impact of PM exposure on the ocular surface, integrating results from preclinical in vitro and in vivo studies with clinical findings to provide a comprehensive understanding of molecular mechanisms, physiological effects, clinical implications, and potential therapies to target acute and chronic PM-induced ocular toxicity.

Methods

A systematic literature search was performed using PubMed and EMBASE over the period from 2009 to 2024 following the recommendations for the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. 102 studies were identified that met the inclusion/exclusion criteria. All studies were assessed for the risk of bias and qualitative data were analyzed.

Results

Preclinical studies using models of corneal and conjunctival cells found that exposure to PM and similar air pollutants resulted in apoptosis, primarily via inflammatory and oxidative stress pathways as well as allergic and immune responses. Animal models resulted in phenotypes reminiscent of that of dry eye disease, presenting with reduced tear volumes and ocular surface damage. These results were corroborated by clinical studies, which reported that patients commonly presented with symptoms of itching, burning, and irritation, and ocular surface signs correlated with a diagnosis of dry eye disease, conjunctivitis, and allergic eye disease.

Conclusions

This systematic review provides a comprehensive summary of our current understanding of PM exposure on the ocular surface, highlighting the correlation between exposure to PM and ocular surface dysfunction.

目的：暴露于颗粒物（PM）和空气污染与眼表疾病（OSD）的病因有关。本系统综述的目的是评估和综合同行评审的PM暴露对眼表影响的文献，将临床前体外和体内研究结果与临床结果相结合，全面了解PM暴露的分子机制、生理效应、临床意义以及针对急性和慢性PM引起的眼毒性的潜在治疗方法。方法：根据系统评价和荟萃分析（PRISMA）报告指南的首选报告项目建议，使用PubMed和EMBASE进行了2009年至2024年期间的系统文献检索。102项研究符合纳入/排除标准。对所有研究进行偏倚风险评估，并对定性数据进行分析。结果：使用角膜和结膜细胞模型的临床前研究发现，暴露于PM和类似的空气污染物导致细胞凋亡，主要通过炎症和氧化应激途径以及过敏和免疫反应。动物模型的结果使人联想到干眼病的表型，表现为泪液体积减少和眼表面损伤。临床研究证实了这些结果，报告患者通常表现为瘙痒、灼烧和刺激症状，眼表体征与干眼病、结膜炎和过敏性眼病的诊断相关。结论：本系统综述全面总结了我们目前对眼表PM暴露的认识，强调了PM暴露与眼表功能障碍之间的相关性。

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引用次数: 0

Pipeline: Pricing for drugs treating dry eye disease 管道：治疗干眼病的药物定价。

IF 5.9 1区医学 Q1 OPHTHALMOLOGY

Ocular Surface

Pub Date : 2025-01-01 DOI: 10.1016/j.jtos.2024.12.004

S. Osman Hussain, Gary D. Novack

引用次数: 0

The effect of botulinum neurotoxin A injections on meibomian glands and dry eye A型肉毒杆菌神经毒素注射对睑板腺和干眼的影响。

IF 5.9 1区医学 Q1 OPHTHALMOLOGY

Ocular Surface

Pub Date : 2025-01-01 DOI: 10.1016/j.jtos.2024.11.009

Ali Sawaed , Shakad Noah Friedrich , Abed Farhan , Aseel Nassar , Mira Hamed , Morris Hartstein , Shirin Hamed Azzam

Purpose

To assess the influence of Botulinum neurotoxin A (BoNT-A) injection on meibomian gland function and dry eye in patients diagnosed with Blepharospasm (BPS) and Hemifacial spam (HFS).

Methods

Adult patients aged 18 years or older who suffer from periocular dystonia, and were treated with BoNT-A injections, were recruited in this interventional prospective study between 2023 and 2024. Each patient was followed up for a period of three months. The following parameters were compared at baseline, 14 and 90 days post BoNT-A injections: Visual acuity, meibography, tear break up time (TBUT), Schirmer test, meibum expression, tear meniscus height, fluorescein corneal staining, meibomian gland dysfunction (MGD) grading, and ocular surface disease index (OSDI). In addition, patients underwent subjective quality of life questionnaire for BPS and HFS.

Results

Thirty-six eyes of twenty-six patients were included in this study. The mean age ±SD was 59 ± 17.33 years. There was a significant statistical difference in vascular changes on the lid margin, TBUT, corneal and conjunctival fluorescein staining and meibum expression (P < 0.001 in all). The differences were statistically significant when compared to baseline vs visit 2, and visit 2 vs visit 3 (p-value<0.05). Jankovic rating scale and HFS score improved significantly between the time periods (P < 0.001 in both).

There was no significant difference in meibomian gland loss, tear meniscus height, Schirmer test, and OSDI.

Conclusion

BoNT-A injection is an effective treatment for periocular dystonia, but it worsens ocular surface and dry eye disease. Moreover, it affects the meibomian glands by disturbing their secretion.

目的：探讨肉毒杆菌神经毒素A （BoNT-A）注射对眼睑痉挛（BPS）和半面部痉挛（HFS）患者睑板腺功能和干眼的影响。方法：在2023年至2024年期间招募18岁及以上患有眼周肌张力障碍并接受BoNT-A注射治疗的成年患者进行这项干预性研究。每位患者随访3个月。在BoNT-A注射后的基线、14和90天比较以下参数：视力、meibography、泪液破裂时间（TBUT）、Schirmer试验、meibum表达、泪液半月板高度、角膜荧光素染色、睑板腺功能障碍（MGD）分级和眼表疾病指数（OSDI）。此外，对患者进行BPS和HFS主观生活质量问卷调查。结果：26例患者36只眼纳入本研究。平均年龄±SD为59±17.33岁。两组间眼睑缘血管变化、TBUT、角膜及结膜荧光素染色及细胞间膜表达差异均有统计学意义(p)。结论：BoNT-A注射治疗眼周肌张力障碍有效，但会加重眼表及干眼症。此外，它通过干扰睑板腺的分泌来影响睑板腺。

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引用次数: 0

Prevalence of dry eye disease among Hong Kong aquatic athletes before and after COVID-19: An exploratory study 新冠肺炎前后香港水上运动员干眼病患病率的探索性研究

IF 5.9 1区医学 Q1 OPHTHALMOLOGY

Ocular Surface

Pub Date : 2025-01-01 DOI: 10.1016/j.jtos.2024.11.010

Ming Hong Wong , Anqi Lyu , Yu Him Lam, Zoe Yau, Allen MY. Cheong

引用次数: 0

Deciphering S1P downregulation and sphingolipid homeostasis disruption in fungal keratitis via multi-omics and MALDI-MSI analysis 通过多组学和MALDI-MSI分析解读真菌性角膜炎中S1P下调和鞘脂稳态破坏。

IF 5.9 1区医学 Q1 OPHTHALMOLOGY

Ocular Surface

Pub Date : 2025-01-01 DOI: 10.1016/j.jtos.2024.12.001

Zhenyuan Fu , Jing Zhong , Lixia Lin , Jiahui Yang , Yichen Xiao , Lei Li , Jing Zhang , Jin Yuan

Purpose

The absence of effective treatment strategies in Fungal Keratitis (FK) emphasizes the critical need to understand the pathogenic mechanisms to enhance therapeutic outcomes. Sphingolipids have been proved to play a pivotal role in the pathogenesis of fungal infections, but the specific alteration in sphingolipids and regulatory pathways remain elusive. Our aim is to gain insight into the pathophysiological mechanisms of sphingolipid homeostasis in FK through multi-omics analysis.

Methods

Matrix-assisted laser desorption/ionization-mass spectrometry imaging (MALDI-MSI) was performed in FK patients and mouse model. Furthermore, time-course RNA-seq was performed and Weighted gene co-expression network analysis (WGCNA) was used to reveal the driver genes in FK. We further investigated the effect of FTY-720, a mimetic of sphingosine 1-phosphate (S1P), on the progression of FK.

Results

MALDI-MSI analysis of FK patients revealed a downregulation of sphingolipids, with sphingolipid metabolism identified as the most prominently enriched pathway. These alterations were validated in mouse model, in which S1P, ceramide, ceramide 1-phosphate and sphingomyelin were found to be downregulated. Time-course transcriptomic analysis suggests that degradation of sphingolipids by specific enzymes drives the progression of FK, involving phospholipid degradation, downregulation of TOR pathway, and activation of innate immune response. Consequently, epithelial cell function was inhibited and cell death increased. Importantly, restoring sphingolipid homeostasis by FTY-720 reversed the level of S1P and relieved the progression of FK.

Conclusion

In summary, this study reveals that disruption of sphingolipid homeostasis promotes disease progression in FK. Furthermore, restoring sphingolipid homeostasis emerges as a promising strategy to mitigate the progression of FK.

目的：真菌性角膜炎（FK）缺乏有效的治疗策略，因此迫切需要了解其致病机制以提高治疗效果。鞘脂已被证明在真菌感染的发病机制中起关键作用，但鞘脂的具体改变和调控途径仍是未知的。我们的目的是通过多组学分析来深入了解FK中鞘脂稳态的病理生理机制。方法：采用基质辅助激光解吸/电离-质谱成像（MALDI-MSI）对FK患者和小鼠模型进行研究。此外，采用时程RNA-seq和加权基因共表达网络分析（WGCNA）来揭示FK的驱动基因。我们进一步研究了1-磷酸鞘氨醇（S1P）模拟物FTY-720对FK进展的影响。结果：FK患者MALDI-MSI分析显示鞘脂下调，其中鞘脂代谢是最显著的富集途径。这些变化在小鼠模型中得到验证，在小鼠模型中发现S1P、神经酰胺、神经酰胺1-磷酸和鞘磷脂下调。时间过程转录组学分析表明，特定酶降解鞘脂驱动FK的进展，包括磷脂降解、TOR通路下调和先天免疫反应的激活。因此，上皮细胞功能受到抑制，细胞死亡增加。重要的是，通过FTY-720恢复鞘脂稳态可以逆转S1P水平，缓解FK的进展。结论：总之，本研究揭示鞘脂稳态的破坏促进了FK的疾病进展。此外，恢复鞘脂稳态是缓解FK进展的一种有希望的策略。

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引用次数: 0

Systems biology of dry eye: Unraveling molecular mechanisms through multi-omics integration 干眼症的系统生物学：通过多组学整合揭示分子机制。

IF 5.9 1区医学 Q1 OPHTHALMOLOGY

Ocular Surface

Pub Date : 2024-12-31 DOI: 10.1016/j.jtos.2024.12.010

Zhirui Zhang , Changxing Liu , Lingying Zhao , Jing Yao

Dry eye disease (DED) is a multifactorial condition with complex and incompletely understood molecular mechanisms. Advances in multi-omics technologies, including genomics, transcriptomics, proteomics, metabolomics, and microbiomics, have provided new insights into the pathophysiology of DED. Genomic analyses have identified key genetic variants linked to immune regulation and lacrimal gland function. Transcriptomic studies reveal upregulated inflammatory pathways in ocular surface tissues, implicating these as core drivers of chronic inflammation. Proteomic research highlights significant alterations in tear protein composition, especially proteins involved in inflammation and tissue repair. Metabolomics studies focus on disrupted lipid metabolism and oxidative stress, which are crucial in maintaining tear film stability. Furthermore, microbiome research has demonstrated reduced microbial diversity and increased pathogenic bacteria, exacerbating inflammatory responses. The integration of multi-omics data allows for the identification of novel biomarkers and therapeutic targets, enabling precision diagnostics and personalized treatments. Therefore, this review highlights the critical importance of multi-omics approaches in deepening our understanding of DED's complex molecular mechanisms and their potential to transform clinical management and therapeutic innovations in this challenging field.

干眼病（DED）是一种多因素疾病，其分子机制复杂且尚未完全了解。多组学技术的进步，包括基因组学、转录组学、蛋白质组学、代谢组学和微生物组学，为DED的病理生理提供了新的见解。基因组分析已经确定了与免疫调节和泪腺功能相关的关键遗传变异。转录组学研究揭示了眼表组织中炎症通路的上调，暗示这些通路是慢性炎症的核心驱动因素。蛋白质组学研究强调了泪液蛋白组成的显著改变，特别是涉及炎症和组织修复的蛋白质。代谢组学研究的重点是破坏脂质代谢和氧化应激，这是维持泪膜稳定性的关键。此外，微生物组研究表明，微生物多样性减少，致病菌增加，加剧了炎症反应。多组学数据的整合允许识别新的生物标志物和治疗靶点，从而实现精确诊断和个性化治疗。因此，这篇综述强调了多组学方法在加深我们对DED复杂分子机制的理解以及它们在这一具有挑战性的领域改变临床管理和治疗创新的潜力方面的重要性。

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引用次数: 0

Clinical practice patterns in the management of dry eye disease: A TFOS international survey 2023-24 干眼病管理的临床实践模式：TFOS国际调查2023-4。

IF 5.9 1区医学 Q1 OPHTHALMOLOGY

Ocular Surface

Pub Date : 2024-12-30 DOI: 10.1016/j.jtos.2024.12.008

James S. Wolffsohn , David A. Semp , Debarun Dutta , Lyndon Jones , Jennifer P. Craig , the TFOS ambassadors

Aims

To understand current clinical management of dry eye disease (DED), based on its perceived severity and subtype, by practitioners across the world.

Methods

The content of the anonymous survey was chosen to reflect the DED management strategies reported by the Tear Film and Ocular Surface Society (TFOS) second Dry Eye Workshop (DEWS II). Questions were designed to ascertain practitioner treatment choice, depending on the subtype and severity of DED. It was first created in English and then translated/back-translated into 14 languages for online completion.

Results

Completed surveys were received from 905 eye care practitioners (52 % optometrists and 42 % ophthalmologists) from across the globe. Many treatment strategies for DED were observed to be utilised by respondents, independent of severity and subtype, the most common being advice (82 %), low (82 %) and high (81 %) viscosity unpreserved lubricants and lid wipes/scrubs (79 %). Several treatments were prescribed across all severity levels (scaled from 1 mild to 10 severe), such as advice (median 4.5, range 4.8), artificial tears (median 5.1, range 4.6) and nutritional supplements (median 5.3, range 4.2). Others were prescribed more frequently with increasing disease severity, for instance, biologics (median 8.2, range 2.8) and surgical approaches (median 8.1, range 2.2). While a similar number of practitioners reported prescribing advice, artificial tears and anti-inflammatories regardless of DED subtype, the commonly reported approaches for aqueous deficient DED were punctal occlusion, therapeutic contact lenses and secretagogues, while the use of oral essential fatty acids, topical lipid-containing products, lid hygiene and lid warming were the preferred management choices for evaporative DED.

Conclusions

There remains great variability in clinical approaches to DED management and until research-evidence definitively informs improved guidance, data from this survey may be useful for clinicians to benchmark their practice.

目的：了解目前干眼病（DED）的临床管理，基于其严重程度和亚型被世界各地的从业人员感知。方法：选择匿名调查的内容来反映泪膜和眼表学会（TFOS）第二届干眼研讨会（DEWS II）报告的DED管理策略。根据DED的亚型和严重程度，设计问题以确定医生的治疗选择。它最初是用英语创建的，然后被翻译/反翻译成14种语言供在线完成。结果：收到了来自全球905名眼科医生（52%验光师和42%眼科医生）的完整调查。调查发现，受访者使用了许多治疗DED的策略，与严重程度和亚型无关，最常见的是建议（82%），低（82%）和高（81%）粘度未保存的润滑剂和擦盖/擦洗（79%）。针对所有严重程度（从1轻度到10严重）规定了几种治疗方法，例如建议（中位数4.5，范围4.8），人工泪液（中位数5.1，范围4.6）和营养补充剂（中位数5.3，范围4.2）。随着疾病严重程度的增加，其他药物的使用频率也会增加，例如，生物制剂（中位数8.2，范围2.8）和手术方法（中位数8.1，范围2.2）。尽管类似数量的从业者报告了处方建议、人工泪液和抗炎药，但大多数报告的水缺乏性DED的治疗方法是点状闭塞、治疗性隐形眼镜和分泌剂，而使用口服必需脂肪酸、局部含脂产品、眼睑卫生和眼睑加热是蒸发性DED的首选治疗选择。结论：在DED管理的临床方法中仍然存在很大的差异，在研究证据明确地告知改进的指导之前，临床医生可以使用该调查的数据来基准他们的实践。

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引用次数: 0

Epidemiological insights into Childhood vernal keratoconjunctivitis in India: Unravelling clinical presentation and environmental influences – The EPIC VKC study – Fourth report of the ICMR EYE SEE study group 印度儿童春季角结膜炎流行病学透视：揭示临床表现和环境影响--EPIC VKC 研究--ICMR EYE SEE 研究小组的第四份报告。

IF 5.9 1区医学 Q1 OPHTHALMOLOGY

Ocular Surface

Pub Date : 2024-12-30 DOI: 10.1016/j.jtos.2024.12.007

Yogita Gupta , Radhika Tandon , Praveen Vashisht , Vivek Gupta , Jyoti Bhuyan , Sachchidanand Singh , G.V.S. Murthy

Purpose

To study the epidemiology and clinical presentation of allergic eye diseases (AEDs) and Vernal Keratoconjunctivitis (VKC).

Methods

A cross-sectional- cum-cohort study was conducted in rural and urban areas in different geographical locations (plains, hilly, high-altitude and coastal) in India. Children (5–15 years) were included, information on exposure to environmental factors gathered, participants screened for AED and VKC on torch light, followed by a comprehensive eye examination. Cases were compared with controls. Physical environmental parameters (ultraviolet A/UVA flux) were also measured.

Results

In all, 8231 participants were screened, 410 had AED (56 % males, mean age 13.7 ± 4.5 years) and 92 had VKC (66.3 % males, mean age 14.5 ± 4.4 years). The likelihood of AED was higher for ages 11–16 years (OR 1.51, p < 0.03, urban areas (OR 1.44, p = 0.049), poor socioeconomic status (OR 1.5, p = 0.007), exposure to smoke of incense sticks (OR 1.88, p = 0.001), bright sunlight (OR 3.56, p < 0.0001), dust/pollution exposure (OR 2.49, p = 0.001) and winter season (OR 2.73, p = 0.003). AEDs were less likely in coastal areas (OR 0.14, p < 0.001). Exacerbating influences for VKC were windy weather (OR 4.35, p = 0.01) and spring season (OR 13.45, p = 0.001). VKC prevalence was higher in rural (69.6 %) than urban areas (30.4 %) (p = 0.03); with 11.9 % visual impairment. Palpebral VKC was the commonest type (82.6 %). Maximum UVA mean flux was noted in plains.

Conclusion

The prevalence of AEDs and VKC in the community is 4.98 (95%CI: 4.51–5.45)% and 1.11 (95%CI: 0.89–1.34)%, respectively. AEDs have association with pollution or dust exposure and winter season. Palpebral VKC is the commonest clinical form of VKC.

目的：研究过敏性眼病（AEDs）和春性角膜结膜炎（VKC）的流行病学和临床表现。方法：在印度不同地理位置（平原、丘陵、高海拔和沿海）的农村和城市地区进行横断面和队列研究。纳入儿童（5-15岁），收集环境因素暴露信息，对参与者进行AED和手电筒光下VKC筛查，然后进行全面的眼睛检查。将病例与对照组进行比较。物理环境参数（紫外线A/UVA通量）也进行了测量。结果：总共筛查了8231名参与者，其中410名患有AED（56%男性，平均年龄13.7±4.5岁），92名患有VKC（66.3%男性，平均年龄14.5±4.4岁）。结论：社区AED患病率为4.98 (95%CI: 4.51 ~ 5.45)%， VKC患病率为1.11 (95%CI: 0.89 ~ 1.34)%；除颤器与污染或粉尘暴露和冬季有关。睑部VKC是临床上最常见的VKC。

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引用次数: 0