CAJ | 학술논문

圆锥角膜是一种双眼进展的，非炎症性的角膜基质变薄的疾病，它以角膜锥形扩张及一系列角膜曲率改变为特征。与它发生相关的可疑因素包括遗传机制、家族相关、过敏性疾病及特异性疾病等，但是环境因素比如非正常性揉眼、角膜接触镜的配戴及紫外线的暴露等却往往易被忽视，虽然对于圆锥角膜的发生、发展普遍认为是一种多因素介导的多种病理过程共同作用的结果，但是这些慢性损伤可能在疾病的发生发展中起着关键性作用。即使现在对它的定义仍然是一种非炎症型的角膜扩张性营养不良性病变，但近年来越来越多的临床证据及实验结果表明圆锥角膜的发生是由于角膜表面长期持续存在的慢性损伤，导致角膜上皮细胞炎性因子过度释放及角膜基质金属蛋白酶的过度表达，从而使角膜基质的酶代谢失调和细胞凋亡程序的启动，最终导致角膜基质细胞的丢失，角膜抗张强度下降和角膜锥形扩张。在此，对目前已知的一些关于角膜慢性损伤与圆锥角膜关系的文章进行综述，并对其可能存在的因果关系进行阐述及讨论。
원추각막시일충쌍안진전적，비염증성적각막기질변박적질병，타이각막추형확장급일계렬각막곡솔개변위특정。여타발생상관적가의인소포괄유전궤제、가족상관、과민성질병급특이성질병등，단시배경인소비여비정상성유안、각막접촉경적배대급자외선적폭로등각왕왕역피홀시，수연대우원추각막적발생、발전보편인위시일충다인소개도적다충병리과정공동작용적결과，단시저사만성손상가능재질병적발생발전중기착관건성작용。즉사현재대타적정의잉연시일충비염증형적각막확장성영양불량성병변，단근년래월래월다적림상증거급실험결과표명원추각막적발생시유우각막표면장기지속존재적만성손상，도치각막상피세포염성인자과도석방급각막기질금속단백매적과도표체，종이사각막기질적매대사실조화세포조망정서적계동，최종도치각막기질세포적주실，각막항장강도하강화각막추형확장。재차，대목전이지적일사관우각막만성손상여원추각막관계적문장진행종술，병대기가능존재적인과관계진행천술급토론。
Keratoconus is a progressive, non - inflammatory corneal thinning disorder that produces a unique spectrum of change in the surface curvature of the cornea. The suspected factors associated with the cause of keratoconus include genetic mechanisms, familial associations, allergy, atopy and so on, but environmental factors, such as abnormal rubbing, contact lens wearing and ultraviolet radiation may be easily ignored. Although it is commonly thought that keratoconus is a result of various pathological progress mediated by multiple factors, those chronic trauma could play important roles in the pathological progress. The classic definition of keratoconus is still referred as a non - inflammation disorder with malnutrition of keratectasia, more and more clinical evidences and experimental results that may refute this concept. It may be due to the long-term persistent chronic trauma resulted from eye rubbing, contact lens or ultraviolet radiation. Under this conditions, the increased release of inflammatory mediators and matrix metalloproteinases may accelerate keratocyte apoposis and enzyme metabolism disorders, with the result of matrix cell lost, tensile strength decreased and keratectasia. Here, for some papers known about the relationship between chronic cornea trauma and keratoconus were reviewed and discussed its possible causal relationship.