春季角结膜炎发生圆锥角膜的机制研究进展

Advances in the mechanisms of keratoconus secondary to vernal keratoconjunctivitis

摘要:

春季角结膜炎是一种好发于儿童及青少年，以反复发作的慢性炎症为主要表现的过敏性眼表疾病，容易出现角膜并发症如圆锥角膜。圆锥角膜是一种以角膜局部圆锥样突起为主要特征的角膜病变。既往研究分别提出了春季角结膜炎及圆锥角膜的发病机制及前者进展为后者的危险因素，但具体机制尚不明确。回顾文献发现二者有共同的发生机制及类似的细胞因子表达，包括Ⅰ型及Ⅳ型超敏反应、炎症反应、酶学变化、氧化应激、机械性损伤等方面。文章旨在概述春季角结膜炎发生圆锥角膜的机制及可能涉及的细胞因子，以期为春季角结膜炎发生圆锥角膜的预防和临床诊疗策略提供参考。

Abstract:

Vernal keratoconjunctivitis is an allergic ocular surface disease mostly present with recurrent chronic inflammation, which usually affects children and adolescents and possibly results in corneal complications such as keratoconus. Keratoconus is a corneal disease characterized by a local cone-like corneal deformation. Previous studies have respectively put forward pathological mechanisms of vernal keratoconjunctivitis and keratoconus and the progressive risk factors, among which we find there's mutual mechanisms as well as cytokines' expression, including type I and IV hypersensitivity, inflammatory reaction, enzymatic changes, oxidative stress and mechanical injury. This review aims at summarizing the possible intrinsic mechanisms and cytokines exacerbating vernal keratoconjunctivitis patients corneas to keratoconus, so as to provide reference for the prevention and management in keratoconus caused by vernal keratoconjunctivitis.