Rosacea Keratitis with Corneal Perforation: 2-Case Report

玫瑰痤瘡角膜炎合併角膜破裂－兩個病例報告

陳韻如(Yun-Ju Chen) ； 王一中(I-Jong Wang) ； 陳偉勵(Wei-Li Chen) ； 胡芳蓉(Fung-Rong Hu) ； 侯育致(Yu-Chih Hou)

《中華民國眼科醫學會雜誌》 49卷4期 (2010/12) Pp. 593-599

https://doi.org/10.30048/ACTASOS.201012.0011

摘要

目的：報告因玫瑰痤瘡角膜炎(rosacea keratitis)導致嚴重角膜破裂的兩個病例。
方法：病例報告。
結果：兩位分別為16及11歲的女性，主訴數年的慢性紅眼及畏光的病史，同時伴隨單眼視力減退。眼睛檢查可見慢性眼瞼緣結膜炎及角膜混濁、新生血管等變化。年齡較大的16歲患者同時台併有臉部皮膚的玫瑰痤瘡表現。兩位患者都囚嚴重的角膜破裂而需接受層狀角膜移植手術，我們同時給予口服tetracycline或doxycycline和類固醇眼藥水控制發炎反應，術後角膜状况穩定，臨床症狀也獲得緩解。
結論：玫瑰痤瘡角膜炎有可能導致嚴重的角膜破裂，早期的診斷治療相形重要：在急性期，角膜手術可搶救視力，但是全身性的tetracycline或doxycycline及類固醇類眼藥水也是必須的，以抑制發炎反應、避免復發。

並列摘要

Purpose: To report two cases of ocular rosacea with corneal perforation
Method: Interventional case report
Result: Two young females presented with a history of recurrent red eye and photophobia in both eyes for years, and had received intermittent topical medication elsewhere. They both had gradually decreased vision in one eye. They also had chronic blepharoconjunctivitis and corneal opacities with neovascularization formation. Corneal melting and perforation occurred in one eye later. One of them had facial erythema and telangiectasia. We performed lamellar keratoplasty combined with topical 0.1% betamethasone and 0.3% ciprofloxacin 4 times daily. 250 mg of oral tetracycline 4 times daily or 100mg of doxycycline twice a day were also added. After the treatment, the ocular surface became silent and the corneal neovascularization decreased.
Conclusion: Ocular rosacea may cause severe complications such as melting, and even perforation. Lamellar keratoplasty can preserve vision in cases of corneal perforation. The combined usage of topical steroid and systemic tetracycline or doxycycline can decrease ocular inflammation and recurrence.

並列關鍵字

Rosacea ； keratitis ； corneal perforation