Retrospective Analysis Of Immunologic Keratitis In 33 Cases

OBJECTIVE:To investigate and analyze the the epidemiological characteristics and clinical features of 33 cases who suffered from Immunologic keratitis in our hospital,and compare the clinical efficacy of drugs and surgery for Immunologic keratitis.Methods:Collect the base data of 35 eyes of 33 patients which were admittedby the from Qilu Hospital of ShanDong University from October 2010 to October 2018 and investigate and analyze the characteristics,pathogenesis,clinical features,diagnosis and treatment.Results:1.The patients' age ranged from 23 years old to 77 years old,the average age of male was(51.29±15.61)and the average age of female was(55.22±15.21);The ratio of male to female was 1.1:1;93.93%(31/33)of these cases were suffered from bilateral disease.In the 21 cases of Mooren'sulcer,the patients' age ranged from 25 years old to 70 years old,The ratio of male to female was 1.3:1,19 cases(57.58%)of township residents,the ratio of city:township = 1:1.36;21 cases(63.6%)of Mooren'sulcer;10 cases(30.3%)of keratitis caused by systemic autoimmune diseases.2.The lesions in 33 eyes mainly involved the superior limbus in 2 cases(6.06%),mainly involved the lower limbus in 3 cases(9.09%),mainly involved the nasal limbus in 12 cases(36.37%),mainly involved the temporal limbus 11 cases(33.33%).3.Of the 33 patients with immunologic keratitis,15(45.46%)had three abnormalities of rheumatism;among them,the detection rate of erythrocytesedimentation rate(ESR)was 13(39.39%);the positive rate of rheumatoid factor was 5(15.15%);Eight patients with abnormalities(24.24%),6 patients with positive ANCA screening test(18.18%),and 7 patients with Mooren'sulcer showed abnormal immunological indicators,without confirmed systemic autoimmune diseases.4.35 eyes were divided into groups:mild group:lesions invaded the limbus<1/3 and the depth of invasion did not reach the deep stromal;severe group:lesion invasion of the limbus circumference>1/3 and/or depth of invasion reached the deep stromal.There were 18 patients(54.54%)the mild group and 15 patients(45.46%)with severe keratitis in the severe group.Among the 18 cases of mild keratitis,13 cases were treated with simple drug,and the effective rate was 84.62%;in 15 cases of severe keratitis,3 cases were treated with simple drug therapy,and the effective rate was 33.33%.In the mild group,18 cases were treated with drug therapy and surgical treatment,the effective rate was 100%;in 15 cases of severe keratitis,12 cases were treated with drug therapy and surgical treatment,and the effective rate was 75.0%.Conclusion:Mooren's corneal ulcer is the most common form of Immunologic keratitis,followed by keratitis caused by systemic autoimmune disease.Patients with mild corneal ulcer can be treated with simple drug therapy,while patients with severe corneal ulcer should be treated with surgical treatment combined with drugs therapy.