The etiologic and pathogenic spectrum of exposure keratopathy: Diagnostic and therapeutic implications

IF 5.9 2区 医学 Q1 OPHTHALMOLOGY
Alejandro Rodriguez-Garcia MD , Raul E. Ruiz-Lozano MD , Raul H. Barcelo-Canton MD , Hector M. Marines-Sanchez MD , J. Homar Paez-Garza MD
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引用次数: 0

Abstract

Exposure keratopathy (EK) is an underestimated ocular surface disorder that involves multiple underlying pathophysiologic mechanisms. It results from an exposed cornea due to different causes of eyelid insufficiency or blinking dysfunction, ocular globe protrusion, a negative orbital vector, and diverse contributing factors leading to impaired ocular surface homeostasis and the potential for vision loss. EK can be congenital, acquired, or induced, and various risk factors predispose patients to corneal exposure. These causes can be grouped into those related to proptosis and eyelid malformations, malfunctioning, or acquired deformity.
If detected early, EK offers a range of effective treatment options. The superficial punctate keratitis and dryness of the cornea's lower third can be successfully treated at the initial stages; however, if left untreated, EK can progress to extensive epithelial erosion, persistent epithelial defects, stromal melting, vascularization, squamous metaplasia, and opportunistic infections, leading to significant visual loss. Different and varied treatment modalities, including medical and surgical, are available for patients with EK, depending on the disease stage, the underlying mechanism, and the cause.
We examine the risk factors, causes, and range of pathologies associated with EK. Exploring the mechanisms that contribute to the development of the disorder's clinical manifestations provides valuable insights that can help clinicians detect and diagnose the disease promptly and plan appropriate targeted treatments.
暴露性角膜病的病因和致病范围:诊断和治疗意义。
暴露性角膜病变(EK)是一种被低估的眼表疾病,涉及多种潜在的病理生理机制。由于眼睑功能不全或眨眼功能障碍、眼球突出、负眼窝矢量以及多种因素导致眼表面稳态受损和潜在的视力丧失,导致角膜暴露。EK可以是先天性的、获得性的或诱发性的,各种危险因素使患者易患角膜病变。这些原因可分为那些相关的突出和眼睑畸形,功能障碍,或获得性畸形。如果发现早期,EK提供了一系列有效的治疗选择。浅表性点状角膜炎和角膜下三分之一的干燥可在初期成功治疗;然而,如果不及时治疗,EK可发展为广泛的上皮侵蚀、持续的上皮缺陷、基质融化、血管化、鳞状皮化生和机会性感染,导致严重的视力丧失。根据疾病分期、潜在机制和病因,EK患者可采用不同的治疗方式,包括内科和外科治疗。这篇综述彻底检查了与EK相关的危险因素、原因和病理范围。探索导致疾病临床表现发展的机制提供了有价值的见解,可以帮助临床医生及时发现和诊断疾病并计划适当的靶向治疗。
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
Survey of ophthalmology
Survey of ophthalmology 医学-眼科学
CiteScore
10.30
自引率
2.00%
发文量
138
审稿时长
14.8 weeks
期刊介绍: Survey of Ophthalmology is a clinically oriented review journal designed to keep ophthalmologists up to date. Comprehensive major review articles, written by experts and stringently refereed, integrate the literature on subjects selected for their clinical importance. Survey also includes feature articles, section reviews, book reviews, and abstracts.
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