麻風病眼部病變-1 004例麻風病患者的研究

Ocular involvement in leprosy-A field study of 1 004 patients

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摘要：

目的:探討麻風病患者的眼部病變的流行病學和眼部疾病類型.方法:眼科醫生歷經3a就各自治療中心的麻風病患者進行了檢查,記錄視力后,手電筒和放大鏡觀察眼前節,Schiotz眼壓計測量眼內壓,tropicamide眼水散大瞳孔后,直接眼底鏡檢查眼底.結果:麻風病患者1 004例中,530例屬瘤性麻風,413例屬結核樣型麻風,61例屬界限類麻風,606例(60.3%)患者出現了與麻風病有關的眼部損害,其中,角膜改變(81.1%)最多見,其次是眼瞼改變(42.1%),在這些患者中,還發現了可引起潛在性的視力損害的疾患,如兔眼癥(17.3%)、角膜知覺麻痹(36.1%)、虹膜睫狀體炎(17.3%),無1例患者出現與麻風病有關的眼底改變,177例(17.6%)麻風病患者患有白內障,169例(16.8%)因麻風病而失明,慢性虹膜睫狀體炎及其并發癥是失明患者最常見的病因.結論:60.3%的麻風病患者發現了眼部改變,其中2/3患者伴有角膜損害,它是最常見的及對視力危害最大的疾患,16.8%的患者因麻風病而失明,早期發現麻風病患者的眼部損害和早期治療潛在性的視力損害及白內障可降低麻風病患者的致盲率.

Abstract：

AIM: To determine the prevalence of ocular involvement and pattern of ocular morbidity in leprosy patients.METHODS: Leprosy patients were examined in their respective treatment centres by the ophthalmologist over a period of three years. After recording visual acuity, anterior segment was examined with torch light and magnifying loupe.Intraocular pressure was measured with Schiotz tonometer.Fundus was examined, after dilating pupils with tropicamide eye drops, with direct ophthalmoscope.RESULTS: Out of 1 004 patients examined, 530 were suffering from lepromatous leprosy, 413 from tuberculoid leprosy, 61 from borderline leprosy. Ocular lesions related to leprosy were noted in 606 (60.3%) patients. Corneal changes (81.1%) were the most frequently observed lesions followed by eyelid changes (42.1%). Potentially sight threatening lesions such as lagophthalmos (17.3%), corneal anaesthesia (36.1%), and iridocyclitis (14.7%) were seen in these patients. None of the patients showed any fundus changes related to leprosy. Cataract, not related to systemic disease,was noted in 177 (17.6%) leprosy patients. Blindness related to leprosy was seen in 169 (16.8%) patients; chronic iridocyclitis with its complications was the most common cause of blindness in these patients.CONCLUSION: Ocular involvement was seen in 60.3% of leprosy patients; corneal lesions being the most common. One or more potentially sight threatening lesions were seen in two-thirds of these patients. Blindness related to leprosy was seen in 16.8% of patients. Early referral of patients with eye problems and treatment of potentially sight threatening lesions and cataract will reduce the prevalence of blindness in leprosy patients.

作者：	S C Reddy[1]B D Raju[2]
Author：	S C Reddy[1]  B D Raju[2]
作者單位：	印度 Andhra Pradesh,卡基納達 Rangaraya 醫學院眼科 印度 Andhra Pradesh,卡基納達國家消滅麻風病計劃組
期 刊：	國際眼科雜志   ISTIC
Journal：	INTERNATIONAL JOURNAL OF OPHTHALMOLOGY
年，卷(期)：	2007, 7(3)
分類號：	R77
關鍵詞：	麻風病    兔眼癥    角膜知覺麻痹    虹膜睫狀體炎    鞏膜炎    防盲
Keywords：	ocular lesions    leprosy    lagophthalmos    corneal anaesthesia    iridocyclitis    scleritis    blindness
機標分類號：	R75 R77
機標關鍵詞：	麻風病患者    病變    虹膜睫狀體炎    眼部損害    視力損害    visual acuity    眼底鏡檢查    失明    潛在性    結核樣型麻風    角膜知覺    白內障    放大鏡觀察    eye drops    治療中心    早期治療    早期發現    眼底改變    眼部改變    壓計測量
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