关键词: 红斑痤疮, 毛细血管扩张, 睑缘炎, 角膜炎, 角膜血管翳, 干眼

Abstract: Objective To investigate the clinical characteristics and treatment of facial rosacea with ocular damage. Design Retrospective case series. Participants Sixteen cases of facial rosacea with ocular damagewere enrolled from January 2010 to December 2012. The age range at presentation was between 16 and 56 years. Methods 16 cases of medical records were followed up for 12 months. In addition to gross inspecting rosacea lesions of the eyes and face, slitlamp and microscope were used to detect the subtle changes in the face and eyes, particular vascular abnormalities. Tests of tear production and tear breakup time (BUT) were performed in 12 patients with ocular dry sensation. Mites were checked on face and nasal skin, and microbiological examination and culture were performed on the palpebrals. Minocycline hydrochloride was used orally 50 mg, twice one day for 3 to 6 months. Topical corticosteroids (loteprednol suspension eye drop) and antibiotic (levofloxacin) were used 3 times one day until two weeks after ocular changes were negative. Main Outcome Measures Skin changes, ocular changes， Schirmer test and tear film BUT. Results Clinical features: common signs of facial skin showed erythema vasodilation hyperplasia in 16 patients (100%), conjunctival hyperemia and conjunctival vasodilation deformation or hyperplasia in 16 patients(100%), 14 cases (87.5%) of blepharoconjunctivitis and 12 cases (75%) of dry eye. Less common signs were including 4 cases (25%) of inferior corneal tongue and tree-like pannus, 6 cases (37.5%) of facial rhinophyma, 4 cases (25%) of corneal ulcers, 4 cases (25%) of episcleritis and two cases (12.5%) of iridocyclitis. After the medication treatment, skin and eye lesions of all the participants were significantly improved (100%). It showed that erythema of facial and nasal skin, and corneal pannus was subsided, corneal infiltrates and conjunctival hyperemia disappeared. Conclusion Atypical ocular clinical manifestations were often difficult to identify, vascular changes was the basis sign, facial vascular changes were often combined for diagnosis. And it was very effective to use minocycline hydrochloride combined with corticosteroid for facial rosacea with ocular damage. (Ophthalmol CHN, 2014, 23： 121-125)

Key words: rosacea, angiotelectasis, blepharitis, keratitis, corneal pannus, dry eye