麻风病眼部病变—1004例麻风病患者的研究(英文)

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

目的:探讨麻风病患者的眼部病变的流行病学和眼部疾病类型。方法:眼科医生历经3a就各自治疗中心的麻风病患者进行了检查,记录视力后,手电筒和放大镜观察眼前节,Schiotz眼压计测量眼内压,tropicamide眼水散大瞳孔后,直接眼底镜检查眼底。结果:麻风病患者1004例中,530例属瘤性麻风,413例属结核样型麻风,61例属界限类麻风,606例(60.3%)患者出现了与麻风病有关的眼部损害,其中,角膜改变(81.1%)最多见,其次是眼睑改变(42.1%),在这些患者中,还发现了可引起潜在性的视力损害的疾患,如兔眼症(17.3%)、角膜知觉麻痹(36.1%)、虹膜睫状体炎(17.3%),无1例患者出现与麻风病有关的眼底改变,177例(17.6%)麻风病患者患有白内障,169例(16.8%)因麻风病而失明,慢性虹膜睫状体炎及其并发症是失明患者最常见的病因。结论:60.3%的麻风病患者发现了眼部改变,其中2/3患者伴有角膜损害,它是最常见的及对视力危害最大的疾患,16.8%的患者因麻风病而失明,早期发现麻风病患者的眼部损害和早期治疗潜在性的视力损害及白内障可降低麻风病患者的致盲率。

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. Alter recording visual acuity, anterior segment was examined with torch light and magnifying Ioupe. Intraocular pressure was measured with Schiotz tonometer. Fundus was examined, alter 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.