上方角膜缘角结膜炎9例临床分析

目的 分析上方角膜缘角结膜炎（superior limbic keratoconjunctivitis of Theodore，SLK）的临床表现及治疗的特点。设计  回顾性病例系列。研究对象 2013年1月至2015年12月北京同仁医院SLK患者9例。方法 回顾性分析患者的临床病历资料。主要指标 临床表现及治疗情况。结果 9例患者中女性7例（7/9）；平均年龄（40±12）岁；均双眼发病。9例患者裂隙灯下表现为上睑结膜乳头，上方球结膜梯形局限性充血，上方角膜缘新月形灰白色浸润，点簇状荧光素染色。9例中有2例甲状腺功能亢进，其中1例以眼部表现为首发。均眼局部给予人工泪液、低浓度糖皮质激素药物治疗，充血及浸润较重者给予绷带式角膜接触镜。平均治疗时间（4.4±3.7）个月，4例停药后复发，重复治疗全部治愈。结论SLK是一种慢性反复性、双眼发病的上方球结膜和上部角膜缘的炎症。局部低浓度糖皮质激素联合绷带式角膜接触镜治疗有效，但应结合全身病治疗，避免复发。（眼科，2017，26：52-55）

Clinical analyses of 9 cases of superior limbic keratoconjunctivitis of Theodore

 Objective To analyze the clinical features, diagnosis and treatment of superior limbus keratoconjunctivitis (SLK). Design Retrospective case series. Participants Nine cases diagnosed as SLK between January 2013 and December 2015 in Beijing Tongren Hospital. Methods All cases were retrospectively analyzed, including clinical manifestation and treatment. Main Outcome Measures clinical manifestation and treatment outcome. Results 7/9 cases were females, and mean age was 40±12 years. All cases were bilateral. All cases had the similar presentation. Slit lamp examination showed palpebral conjunctival papilla, upper corneal limbus infiltration andfluorescein staining. 2 patients were accompaniedby hyperthyroidism, 1 case with ocular symptoms as the first. Topical treatment included artificial tears, low concentration of steriod drugs. Bandage lens were used for heavier infiltration patients. But SLK recurred in four cases, which were cured completely after re-treatment. Conclusion SLK is a chronic inflammation of the upper conjunctiva and corneal limbus, without obvious hyperemia of remaining parts of the bulbar conjunctiva. Most cases are bilateral. Local use of low concentration steroid eye drops combined with bandage lens is effective for it. The treatment of systemic diseases is essential. Clinicians should pay attention to recurrence of SLK. (Ophthalmol CHN, 2017, 26: 52-55)