Turkiye Klinikleri Journal of Ophthalmology

.: REVIEW
Oküler Rozasea
Ocular Rosacea: Review
Hande ÇELİKERa, Ebru TOKERa
aGöz Hastalıkları AD, Marmara Üniversitesi Tıp Fakültesi, İstanbul
Turkiye Klinikleri J Ophthalmol. 2017;26(4):278-92
doi: 10.5336/ophthal.2017-54801
Article Language: TR
Full Text
ÖZET
Rozasea; cildi etkileyen, kronik, ilerleyici ve nedeni bilinmeyen bir hastalıktır. Rozasea, cildi tutan bir hastalık olmasına rağmen, %58-72 hastada göz kapağı ve oküler yüzeyde inflamasyona neden olabilecek şekilde gözü de etkileyebilmektedir. Rozaseanın etiyolojisi hâlen tam olarak anlaşılamamış olmasına rağmen, immün sistem disfonksiyonu, cilde ait mikroorganizmalara karşı gelişmiş inflamatuar reaksiyon, Demodex folliculorum enfestasyonu, güneş ışığı gibi çevresel faktörler, damarsal anomaliler patogenezde düşünülmektedir. Rozasea tanısı konulabilecek özel bir test hâlen geliştirilememiştir. Oküler rozasea, muayene sırasında göz hekimi hastanın yüzünü yeterince incelemezse sıklıkla atlanabilmektedir. Tanı konulmamış ve tedavi edilmemiş oküler rozasea, oküler morbiditeyi değişik düzeylerde etkileyebilmektedir. Rozasea tanısı koymakta gecikildiği durumda tedavi gecikir ise ağır oküler komplikasyonlar ve körlük görülebilmektedir. Bu hastaların yaklaşık üçte birinde potansiyel olarak görmeyi tehdit edici ciddi kornea komplikasyonları gelişebilmektedir. Oküler rozaseanın tedavisinde; lubrikan ajanlar, topikal steroid ve topikal antibiyotik içeren göz damlaları, merhemleri ve sistemik antibiyotikleri içeren çok sayıda farklı yaklaşımlar ve tedavi seçenekleri mevcuttur. Bu kronik hastalık alevlenmeler ve remisyonlarla seyreden, sıklıkla yaş aralığı 40-60 yıl olan kadınları etkileyen karakterdedir. Bu çalışmada, rozaseanın klinik alt tipleri, etiyopatogenezi için literatürde öne sürülen patofizyolojik mekanizmaların tanımlanması, klinik özellikleri, tanısal yaklaşımları, ayırıcı tanıları ve tedavi yöntemlerinin değerlendirilmesi amaçlanmıştır.

Anahtar Kelimeler: Etiyoloji; rozasea; tedavi
ABSTRACT
Rosacea is a chronic, progressive disease of unknown cause affecting the skin. Although considered a skin disease, rosacea may involve the eyes in 58-72% of the patients, causing eyelid and ocular surface inflammation. Though the etiology of rosacea is not fully understood, immune system dysfunction, inflammatory reaction to cutaneous microorganisms, Demodex folliculorum infestation, environmental factors like sunlight, and vascular anomalies have been considered in its pathogenesis. A diagnostic test for rosacea has not been advanced yet. Ocular rosacea is often underdiagnosed if ophthalmologist does not inspect the patient's face adequately during the ocular examination. Undiagnosed and untreated ocular rosacea may cause varying degrees of ocular morbidity. Severe ocular complications and blindness can occur if the treatment is delayed due to non-diagnosis of the rosacea. About one third of the patients develop potentially sight-threatening corneal involvement. There are several different approaches and treatment choices available for the treatment of ocular rosacea, including lubricating agents, topical steroids, topical antibiotic eye drops and ointments, and systemic antibiotics. It is a chronic disease, characterized by exacerbations and remissions and affects mostly the women whose ages of 40-60. In this review, clinical subtypes of rosacea, describe the pathophysiologic mechanisms proposed in the literature for the etiopathogenesis, clinical features, diagnostic approachs, differential diagnosis and, treatment modalities have been evaluated.

Keywords: Etiology; rosacea; therapy

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30.03.2014

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