SD-OCT检测服用异维A酸患者的眼表上皮厚度变化

摘要

目的:使用频域光学相干断层扫描(SD-OCT)检测口服异维A酸患者角膜及结膜上皮厚度.方法:共64例64眼寻常痤疮患者纳入研究.32例患者为A组,每日口服异维A酸0.5mg/kg.另外32例患者为B组,每日口服异维A酸0.8mg/kg.使用SD-OCT于服药前、治疗45d、4mo以及结束治疗1mo后,检测中央角膜厚度(CCT)、中央角膜上皮厚度(CCET)、中央角膜上皮基底膜厚度(CCEBMT)、非上皮中央角膜厚度(NECCT)和球结膜上皮厚度(BCET).结果:共有44例女性(68.75％)和20例男性(31.25％),平均年龄21.68±3.75岁.在两组中,CCET、CCT和BCET于服药45d、4mo以及治疗结束1mo后较治疗前变薄.CCEBMT于治疗45d以及4mo时降低,但最后一次随访时与治疗前比较差异无统计学意义.治疗中和治疗后NECCT与治疗前相比无明显差异.结论:口服异维A酸治疗的患者,眼表上皮厚度降低,而NECCT未受影响.这些患者角膜上皮厚度降低主要是因为上皮变薄.结束治疗1 mo后,CCEBMT恢复到治疗前水平,眼表上皮厚度有所增加.%AIM:To use in vivo spectral-domain optical coherence tomography (SD-OCT) to investigate ocular surface epithelial thickness changes in patients treated with oral isotretinoin.METHODS:A total of 64 eyes of 64 acne vulgaris patients were enrolled into two group:thirty-two patients received 0.5 mg/kg isotretinoin daily (Group A),and the other 32 patients received 0.8 mg/kg daily (Group B).The central corneal thickness (CCT),central corneal epithelium thickness (CCET),central corneal epithelium basal membrane thickness (CCEBMT),non-epithelial central corneal thickness (NECCT) and bulbar conjunctival epithelium thickness (BCET) were evaluated using SD-OCT at baseline,at the 45th day,at the fourth month of treatment and at the first month after the end of treatment.RESULTS:There were 44 females (68.75％) and 20 males (31.25 ％) with a mean age of 21.68±3.75y.In both groups,CCET,CCT and BCET were significantly thinner at the 45th day,at the fourth month of the treatment and at the first month after the end of treatment as compared with baseline.CCEBMT decreased significantly at the 45th day and at the fourth month of treatment,but there was no difference between the baseline and the last visit.There were no significant difference in NECCT during and after treatment as compared with the baseline.CONCLUSION:Ocular surface epithelial thickness decreased in patients treated with oral isotretinoin,whereas NECCT was not affected.The decreasing corneal thickness in patients treated with isotretinon is mainly due to epithelial thinning.After a one-month cessation of isotretinoin treatment,CCEBMT returned to the baseline value,and ocular surface epithelial thickness increased.