Ocular rosacea is an important and underdiagnosed chronic inflammatory disorder observed in children. A clinical spectrum ranging from chronic eyelid inflammation, recurrent ocular redness, photophobia and/or hordeola...Ocular rosacea is an important and underdiagnosed chronic inflammatory disorder observed in children. A clinical spectrum ranging from chronic eyelid inflammation, recurrent ocular redness, photophobia and/or hordeola/chalazions and conjunctival/corneal phlyctenules evolving to neovascularization and scarring may occur. Visual impairment and consequent amblyopia are frequent and corneal perforation although rare is the most feared complication. Ocular manifestations usually precede cutaneous lesions. Although few cases of pediatric ocular rosacea(POR) have been reported in the literature, many cases must have been underdiagnosed or misdiagnosed. The delay in diagnosis is greater than one year in the large majority of cases and may lead to serious ocular sequelae. This review aims to highlight the clinical features of POR, its epidemiology, easy diagnosis and effective treatment. We also propose new diagnostic criteria, in which at least three of the five clinical criteria must be present:(1) Chronic or recurrent keratoconjunctivitis and/or red eye and/or photophobia;(2) Chronic or recurrent blepharitis and/or chalazia/hordeola;(3) Eyelid telangiectasia documented by an ophthalmologist;(4) Primary periorificial dermatitis and/or primary features of rosacea; and (5) Positive familial history of cutaneous and/or ocular rosacea.展开更多
AIM:To evaluate the efficacy and safety of cyclosporine 1%(CsA)eye drops in patients affected by pediatric blepharokeratoconjunctivitis(PBKC).METHODS:This was a retrospective,single arm study of pediatric patients wit...AIM:To evaluate the efficacy and safety of cyclosporine 1%(CsA)eye drops in patients affected by pediatric blepharokeratoconjunctivitis(PBKC).METHODS:This was a retrospective,single arm study of pediatric patients with PBKC.All patients received topical CsA 1%eye drops,administered three times daily for 2mo and then tapered during the third month.In the first treatment week,chloramphenicol and betamethasone eye drops were also given three times daily.Patients were examined at baseline(T0),4wk(T1),3mo(T2),and 12mo(T3).At each visit,slit-lamp evaluation of the anterior segment and anterior segment photography were performed.Disease activity and damage were assessed using the modified Hamada bimodal scoring system.Mean PBKC scores across time points were compared using oneway ANOVA,followed by Tukey’s HSD post-hoc test.RESULTS:Thirty-six pediatric patients with PBKC were enrolled,six are excluded for incomplete follow-up,leaving 30 patients(11 males,19 females;mean age 7.71±3.86y)for analysis.The baseline activity score was 1.60±0.62 and decreased significantly at all time points(T1:0.53±0.51;T2:0.34±0.76;T3:0.47±0.86;P<0.001).Damage scores declined by 52%at T1,53%at T2,and 70%at T3,with significant reductions at T2 and T3 versus baseline(P<0.01).No adverse events occur during the follow-up.CONCLUSION:CsA 1%eye drops effectively control the signs and symptoms of PBKC in pediatric patients and demonstrate a favorable safety profile,supporting their used as a valid therapeutic option in clinical practice.展开更多
文摘Ocular rosacea is an important and underdiagnosed chronic inflammatory disorder observed in children. A clinical spectrum ranging from chronic eyelid inflammation, recurrent ocular redness, photophobia and/or hordeola/chalazions and conjunctival/corneal phlyctenules evolving to neovascularization and scarring may occur. Visual impairment and consequent amblyopia are frequent and corneal perforation although rare is the most feared complication. Ocular manifestations usually precede cutaneous lesions. Although few cases of pediatric ocular rosacea(POR) have been reported in the literature, many cases must have been underdiagnosed or misdiagnosed. The delay in diagnosis is greater than one year in the large majority of cases and may lead to serious ocular sequelae. This review aims to highlight the clinical features of POR, its epidemiology, easy diagnosis and effective treatment. We also propose new diagnostic criteria, in which at least three of the five clinical criteria must be present:(1) Chronic or recurrent keratoconjunctivitis and/or red eye and/or photophobia;(2) Chronic or recurrent blepharitis and/or chalazia/hordeola;(3) Eyelid telangiectasia documented by an ophthalmologist;(4) Primary periorificial dermatitis and/or primary features of rosacea; and (5) Positive familial history of cutaneous and/or ocular rosacea.
文摘AIM:To evaluate the efficacy and safety of cyclosporine 1%(CsA)eye drops in patients affected by pediatric blepharokeratoconjunctivitis(PBKC).METHODS:This was a retrospective,single arm study of pediatric patients with PBKC.All patients received topical CsA 1%eye drops,administered three times daily for 2mo and then tapered during the third month.In the first treatment week,chloramphenicol and betamethasone eye drops were also given three times daily.Patients were examined at baseline(T0),4wk(T1),3mo(T2),and 12mo(T3).At each visit,slit-lamp evaluation of the anterior segment and anterior segment photography were performed.Disease activity and damage were assessed using the modified Hamada bimodal scoring system.Mean PBKC scores across time points were compared using oneway ANOVA,followed by Tukey’s HSD post-hoc test.RESULTS:Thirty-six pediatric patients with PBKC were enrolled,six are excluded for incomplete follow-up,leaving 30 patients(11 males,19 females;mean age 7.71±3.86y)for analysis.The baseline activity score was 1.60±0.62 and decreased significantly at all time points(T1:0.53±0.51;T2:0.34±0.76;T3:0.47±0.86;P<0.001).Damage scores declined by 52%at T1,53%at T2,and 70%at T3,with significant reductions at T2 and T3 versus baseline(P<0.01).No adverse events occur during the follow-up.CONCLUSION:CsA 1%eye drops effectively control the signs and symptoms of PBKC in pediatric patients and demonstrate a favorable safety profile,supporting their used as a valid therapeutic option in clinical practice.
