非感染性周边溃疡性角膜炎ppt课件.pptVIP

NON INFECTIOUS PERIPHERAL ULCERATIVE KERATITIS [PUK];WHAT IS PUK ?;WHY IN PERIPHERAL CORNEA ?;PATHOPHYSIOLOGY OF DAMAGE IN PUK; CLINICAL PRESENTATION DIAGNOSIS; CLINICAL PRESENTATION DIAGNOSIS - II;EXAMINATION IN PUK;OCULAR EXAMINATION; EXAMINATION;SLIT LAMP EXAMINATION-CORNEA; SLIT- LAMP EXAMINATION SCLERA;SYSTEMIC EXAMINATION;Differential Diagnosis Of PUK;TERRIENS MARGINAL DEGENERATION;;Laboratory Investigations For Non Infectious PUK;LOCAL INVESTIGATIONS;Treatment of Non Infectious PUK ;LOCAL THERAPY Goals;Promote epithelial healing; No role of topical steroids/ NSAIDS ( inhibits collagen synthesis—increases melt) Use topical 1% medroxy progesterone (good anti inflammatory, no collagen synthesis inhibition) Can use topical cyclosporine 0.5- 1% ( local T cell immune modulation) Low dose topical steroids Lid hygeine only in marginal infiltrates with blepharitis ( staph antigen); ;SYSTEMIC THERAPY;INDICATIONS FOR IMMUNE SUPPRESSION;DRUGS USED;DRUGS USED ;Surgical treatment;Surgical treatment;Tectonic lamellar / full thickness corneal / scleral graft – Large Perforation w/ Uveal Prolapse;Simultaneous systemic immunosuppression very important or graft will also melt;LONG TERM MANAGEMENT;LONG TERM MANAGEMENT ;MOORENS ULCER;Distinguishing features;Glue + BCL – if impending perforation increased thinning Systemic steroids and immuno suppressives only if b/l moorens nonresponsive to local therapy Cyclophosphamide, methotrexate : DOC If Hep C Ag + : interferon alpha 2b ( 3 million units tri weekly SC inj – for 6 months;Conclusion..; THANK YOU!