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边缘性角膜溃疡是指近角膜缘处角膜基质的半月形破坏性病变,伴随角膜上皮缺损、基质变性,以及基质炎性细胞浸润。风湿病常累及眼部,类风湿关节炎、Wegener’s肉芽肿、结节性多动脉炎、复发性多软骨炎、系统性红斑狼疮等可发生边缘性角膜溃疡。边缘性角膜溃疡可能是系统性血管炎的首发表现,也可能预示着某些风湿病进入了严重的血管炎阶段。眼科医师了解这些风湿病的全身及眼部表现,做出正确及时的诊断,并协同风湿科医师进行全身性治疗,对于挽救患者的生命和眼睛都是非常重要的。就边缘性角膜溃疡的病因、临床表现及治疗的研究进展进行综述。
Marginal corneal ulcers refer to the meniscus lesion of the corneal stroma at the proximal limbus, with corneal epithelial defects, stromal degeneration, and stromal inflammatory cell infiltration. Rheumatism often affects the eye, rheumatoid arthritis, Wegener’s granuloma, polyarteritis nodosa, recurrent polychondritis, systemic lupus erythematosus and other marginal keratitis can occur. Marginal corneal ulcers may be the first manifestation of systemic vasculitis, may also indicate that some rheumatic diseases have entered a serious stage of vasculitis. It is important for ophthalmologists to understand the systemic and ocular manifestations of these rheumatisms, make correct and timely diagnoses, and work with rheumatologists for systemic treatment to save the patient’s life and eyes. The etiology, clinical manifestations and treatment of marginal corneal ulcer were reviewed.