中国神经营养性角膜炎诊断及治疗专家共识(2021年)

Consensus of experts on diagnosis and treatment of neurotrophic keratitis in China(2021)

神经营养性角膜炎是由三叉神经损伤引起的角膜退行性病变,常见原因包括疱疹病毒感染、颅脑和眼科手术损伤、糖尿病等,可导致干眼、角膜上皮缺损和角膜溃疡。因角膜知觉减退或缺失,患者自觉症状轻,就诊时多已出现严重的角膜基质融解甚至穿孔,且常规对症治疗效果不佳。鉴于目前临床对本病的认识不足,存在大量误诊误治问题,为了提高临床诊疗水平,中华医学会眼科学分会角膜病学组经过充分讨论制定本共识,以供眼科医师在临床工作中参考使用。

Neurotrophic keratitis is a degenerative disease of the cornea caused by impairment in the trigeminal nerve,which can lead to dry eyes,corneal epithelial defects and corneal ulcers.The common causes include herpes virus infection,craniocerebral and ophthalmic surgery injury,and diabetes.Due to the reduced or lack of corneal sensitivity,patients′symptoms are mild,while severe corneal stroma melting or even perforation may occur.And the conventional symptomatic treatment is not effective.In view of the current lack of clinical understanding of this disease,there are a large number of problems of misdiagnosis and mistreatment.To improve the level of diagnosis and treatment,the consensus of experts on diagnosis and treatment of neurotrophic keratitis,which can be used as a reference for ophthalmologists in clinical work,is formulated by the Cornea Group of Chinese Ophthalmological Society.