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摘要

“Bietti角膜病”或气候液滴性角膜病或气候性角膜病(KC)是一种角膜退行性疾病,可能是由于暴露于紫外线所致。通常是由琥珀色结节逐渐侵入角膜,使角膜上皮上升。我们观察到,许多患者患有严重的角膜溃疡,这似乎是自发的,其演变往往是灾难性的。这项工作的目的是收集KC的流行病学数据,以验证以下假设:由于非创伤性穿孔,角膜不透明在患有KC的患者中比在其他人群中更常见。在吉布提共和国进行的这项研究涉及两组人:一组是热情好客的217名KC患者,另一组是随机抽样的2 446名吉布提人,其中一组研究对象是40岁以上的不健康人士。这些错误是通过对年龄和气候条件的调整来控制的。结果是,在患有KC的人群中,自发性角膜失明的发生率明显高于生活在相同条件下的健康人群(12%对0.7%;P = 0.003;年龄调整后的优势比:31.8 IC: 8.8-115.20)。从致病的角度看,细菌性、真菌性和虚假性病因很难被接受。这种不利的进化,对所有的治疗都产生了抗性,促使人们提出了几个假设,其中包括自由阿米巴虫作为棘阿米巴虫的责任。
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[Corneal complications of climatic keratopathy].

The "keratopathie de Bietti" or climatic droplet keratopathy or keratopathie climatique (KC) is a degenerative disease of the cornea which is probably due to the exposure to ultraviolet rays. Usually the evolution is a progressive invasion of cornea by amber nodules which lift up the corneal epithelium. We observed that numerous patients suffered from severe corneal ulcerations which appeared to be spontaneous and which evolution was frequently disastrous. The aim of this work was to pick up epidemiologic data on KC in order to check the following hypothesis: the corneal opaquenesses, due to non traumatic perforations, would be more frequent among patients suffering from KC than among the rest of population. The study, carried out in Republic of Djibouti, dealed with two groups of people: an hospitable group of 217 patients suffering from a KC and a random sample of 2,446 persons among Djibouti people, from which a study ill-healthy was carried out among people from 40 years old. The mistakes were controled by adjustment on age and climatic conditions. The result is that corneal blindnesses which seemed to be spontaneous were more frequent in a significative way among people suffering from KC than among healthy people as old as ill people and living in the same conditions (12% against 0.7%; p = 0.003; Odds ratio adjusted on age: 31.8 IC: 8.8-115.20). On the etiopathogenic point of view the bacterial, fungal and deficiency causes could scarcely be accepted. The unfavourable evolution, resisting to all the treatments, drove to several hypothesis among them is responsibility of free amoebas as acanthamoeba.

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