综述

新型纳米材料介导治疗念珠菌角膜炎研究进展

Research progress on novel nanomaterials mediated treatment of candidal keratitis

:348-354
 

真菌性角膜炎是我国常见的致盲性眼病,其中排前3位的致病病原菌分别为曲霉菌、镰刀菌以及念珠菌。念珠菌作为一种条件致病真菌,在宿主免疫功能低下或眼表微环境失衡时易引发机会性感染,其发病率因免疫抑制药物的滥用以及隐形眼镜佩戴的增加等因素逐年上升。在机会感染后,由于念珠菌本身以及生物膜形成的特殊作用,常导致其对现用系统性抗真菌药物,如伏立康唑、两性霉素B、伊曲康唑及氟康唑等耐药性增加。近年来,关于纳米材料介导的药物传递系统作用于治疗念珠菌角膜炎的研究日益增多,新型纳米材料通过作为抗真菌药物的载体,增加药物溶解度,延长眼表停留时间,加强生物膜、角膜穿透性,提高了抗真菌药物对念珠菌的抗菌作用,为解决念珠菌感染耐药性难题提供了新思路。文章综述了纳米聚合物、纳米颗粒、纳米凝胶、脂质体载体、纳米立方体、纳米微针和纳米胶束等新型纳米材料作为治疗念珠菌角膜炎的新型给药载体的研究现状与进展,突破传统疗法的局限,为改善目前临床存在抗真菌治疗药物有限的问题提供新的可行思路。

Fungal keratitis is a prevalent blinding ocular disease in China, with Aspergillus, Fusarium, and Candida ranking as the top three pathogenic fungi. As an opportunistic pathogenic fungus, Candida readily causes opportunistic infections when host immunity is compromised or the ocular surface microenvironment is imbalanced. The incidence of Candida keratitis has been rising annually due to factors such as the misuse of immunosuppressive drugs and increased contact lens wear. Following infection, Candida itself and the formation of biofilms contribute to enhanced resistance against currently used systemic antifungal agents, including voriconazole, amphotericin B, itraconazole, and fluconazole, posing significant challenges to clinical treatment.Recently, research on nanomaterials-mediated drug delivery systems for treating Candida keratitis has burgeoned. Novel nanomaterials, serving as carriers for antifungal drugs, enhance therapeutic efficacy by improving drug solubility, prolonging ocular surface retention time, penetrating biofilms, and enhancing corneal permeability. These advancements offer new strategies to address drug resistance in Candida infections. This article reviews the research status and progress of emerging nanomaterialssuch as nanopolymers, nanoparticles, nanogels, liposomal carriers, nanocubes, nanoneedles, and nanomicellesas innovative drug delivery vectors for Candida keratitis. By overcoming the limitations of conventional therapies, these nanomaterials provide feasible solutions to the clinical challenges of limited antifungal options and drug resistance. The integration of nanotechnology holds promise for revolutionizing the treatment of Candida keratitis and advancing precision medicine for ocular surface fungal infections.

论著

未行准分子激光角膜屈光手术的原因分析

Analysis of reasons for not performing laser refractive keratomileusis in refractive surgery candidates

:15-19
 

目的:分析有意愿接受准分子激光角膜屈光手术治疗近视的患者在术前检查后未行手术的原因。方法:选取20151月至20176月在安徽医科大学附属第一医院眼科激光中心检查的近视患者,分析其中未行激光手术的原因。结果:2 875例患者准备接受准分子激光角膜屈光手术,其中821(28.6%)检查后未进行手术,男462(56.3%),女359(43.7%),年龄18~51(23.69±5.85)岁。821例中社会心理因素影响484(59.0%),角膜薄或角膜厚度不足182(22.2%),超高度近视(>10.00 D)100(12.2%),高眼压19(2.3%),弱视13(1.6%),角膜曲率异常11(1.3%),眼底病变7(0.9%),角膜变性3(0.4%),其他2(0.2%)结论:近视治疗术前检查后未进行准分子激光角膜屈光手术的原因多种多样,其中社会心理因素及角膜厚度不足是最主要的原因。术前详细检查,严格掌握手术适应证和禁忌证以及充分医患沟通是手术安全的保障。

Objective: To analyze the reasons for not performing laser refractive keratomileusis surgery among refractive surgery candidates under regular preoperative examination. Methods: The patients with myopia examined in the Center of Ophthalmology in the First Affiliated Hospital of Anhui Medical University Laser between January 2015 and June 2017 were selected, the reasons for not performing laser refractive keraomileusis after regular preoperative examination were analyzed. Results: A total of 2 875 patients requested refractive surgery and 2 054 (71.4%) of them received refractive surgery. Among 821 (28.6%) patients who did not get laser refractive keratomileusis, 462 (56.3%) were male and 359 (43.7%) were female, aged 1851 years (range, 23.69±5.85 years). The most common reason for not offering refractive surgery were social psychological factors (59.0%), low central corneal thickness (22.2%), high myopia (12.2%), high intraocular pressure (2.3%), poor corrected visual acuity (1.6%), corneal topography anomaly (1.3%), retinal disease (0.9%), corneal (0.4%) and other diseases (0.2%). Conclusion: Reasons for not performing refractive surgery are quite diverse. Social psychological factors and inadequate corneal thickness were the most common reasons in the present study. Careful preoperative examination, strictly mastering indications and contraindications and full doctor-patient communication should be done for the safety of surgery.

临床病例讨论

内源性念珠菌性眼内炎误诊1例

Misdiagnosis of endogenous Candida endophthalmitis: A case report

:51-53
 
临床上内源性真菌性眼内炎比较少见,其早期临床表现因类似于葡萄膜炎等常见眼病常常被误诊。武汉爱尔眼科医院汉口医院收治了1例49岁女性患者,首诊为葡萄膜炎,后前房穿刺送检确诊为内源性念珠菌性眼内炎。
Endogenous fungal endophthalmitis is easy to be misdiagnosed because it is quite rare and early clinical features resembling uveitis. A 48-year-old female patient was admitted to Wuhan Aier Eye Hospital Hankou Hospital, her first diagnosis was uveitis, and the posterior anterior chamber puncture was confirmed as endogenous Candida endophthalmitis.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
推荐阅读