CAJ | 학술논문

结膜松弛症是一种常见但易被忽略的年龄相关性眼表疾病,其发病机制尚不明确.研究发现,松弛结膜组织表达基质金属蛋白酶上调,引起结膜基质及结膜下Tenon囊降解,导致结膜组织与其下方的巩膜组织不能良好贴附及球结膜松弛;松弛结膜堆积在睑缘内外眦部之间,引起泪液学异常,泪河残缺、泪膜不稳定、影响泪液分布流动,泪湖不能聚泪,或直接阻塞泪小点导致泪液清除延缓;泪液中炎性相关蛋白、凋亡及凋亡调节相关蛋白以及降解酶等表达增高;泪液中的炎性细胞因子可上调结膜成纤维细胞表达基质金属蛋白酶,促进结膜细胞外基质的进一步降解,加重结膜松弛,形成恶性循环.
결막송이증시일충상견단역피홀략적년령상관성안표질병,기발병궤제상불명학.연구발현,송이결막조직표체기질금속단백매상조,인기결막기질급결막하Tenon낭강해,도치결막조직여기하방적공막조직불능량호첩부급구결막송이;송이결막퇴적재검연내외자부지간,인기루액학이상,루하잔결、루막불은정、영향루액분포류동,루호불능취루,혹직접조새루소점도치루액청제연완;루액중염성상관단백、조망급조망조절상관단백이급강해매등표체증고;루액중적염성세포인자가상조결막성섬유세포표체기질금속단백매,촉진결막세포외기질적진일보강해,가중결막송이,형성악성순배.
Conjunctivochalasisis (CCh) not uncommon but often was overlooked as a normal aging variation.The etiology of conjunctivochalasis has not yet to be fully elucidated.Recent studies showed that overexpression of matrix metalloproteinases by conjunctivochalasis fibroblasts,which may help explain how conjunctivochalasis manifests excessive degradation of the conjunctival matrix and Tenon' s capsule,which could cause the lack of adhesion between the conjunctiva and the sclera and conjunctivochalasis.The redundant conjunctiva located between the globe and the eyelid interferes tear meniscus,causing unstable tear film,punctal occlusion and delayed tear clearance.The accumulation of inflammatory protein,apoptosis and apoptosis related proteins and degrading enzymes or other active ingredient in tear fluid are increased due to the delay in tear clearing.Inflammatory cytokines up-regulate the expression of matrix metalloproteinases by conjunctival fibroblasts,which will promote the further degradation of conjunctival extracellular matrix,setting up a vicious cycle to aggravate the existing conjunctivochalasisis.