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abnormal dryness of the conjunctiva and cornea of the eyes; may be due to a systemic deficiency of vitamin A (同)xerophthalmus, xeroma, conjunctivitis arida

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/02 04:53:09」(JST)

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Xerophthalmia (ⁱ/ˌzɪərˌɒfˈθælmiːə/; Greek for dry eyes, from Ξηροφθαλμία = ξηρός, dry + οφθαλμός, eye) is a medical condition in which the eye fails to produce tears. It may be caused by a deficiency in vitamin A and is sometimes used to describe that lack, although there may be other causes.

Xerophthalmia caused by a severe vitamin A deficiency is described by pathologic dryness of the conjunctiva and cornea. The conjunctiva becomes dry, thick and wrinkled. If untreated, it can lead to corneal ulceration and ultimately to blindness as a result of corneal damage.

Xerophthalmia is a term that usually implies a destructive dryness of the conjunctival epithelium due to dietary vitamin A deficiency — a rare condition in developed countries, but still causing much damage in developing countries. Other forms of dry eye are associated with aging, poor lid closure, scarring from previous injury, or autoimmune diseases such as rheumatoid arthritis and Sjögren's syndrome, and these can all cause chronic conjunctivitis. Radioiodine therapy can also induce xerophthalmia, often transiently, although in some patients late onset or persistent xerophthalmia has been observed.^[1]

The damage to the cornea in vitamin A associated xerophthalmia is quite different from damage to the retina at the back of the globe, a type of damage which can also be due to lack of vitamin A, but which is caused by lack of other forms of vitamin A which work in the visual system. Xerophthalmia from hypovitaminosis A is specifically due to lack of the hormone-like vitamin A metabolite retinoic acid, since (along with certain growth-stunting effects) the condition can be reversed in vitamin A deficient rats by retinoic acid supplementation (however the retinal damage continues). Since retinoic acid cannot be reduced to retinal or retinol, these effects on the cornea must be specific to retinoic acid. This is in keeping with retinoic acid's known requirement for good health in epithelial cells, such as those in the cornea.

Epidemiology and mechanical etiology

Xerophthalmia usually affects children under nine years old and "accounts for 20,000-100,000 new cases of childhood blindness each year in the developing countries." The disease is largely found in developing countries like many of those in Africa and Southern Asia. The condition is not congenital and develops over the course of a few months as the lacrimal glands fail to produce tears. Other conditions involved in the progression already stated include the appearance of Bitot's spots, which are clumps of keratin debris that build up inside the conjunctiva and night blindness, which precedes corneal ulceration and total blindness.

Prevention

Prophylaxis consists of periodic administration of Vitamin A supplements. WHO recommended schedule, which is universally recommended is as follows :

Infants 6–12 months old and any older children weighing less than 8 kg - 100,000 IU orally every 3–6 months
Children over 1 year and under 6 years of age - 200,000 IU orally every 6 months
Infants less than 6 months old, who are not being breastfed - 50,000 IU orally should be given before they attain the age of 6 months

Treatment

Treatment can occur in two ways: treating symptoms and treating the deficiency. Treatment of symptoms usually includes use of artificial tears in the form of eye drops, increasing the humidity of the environment with humidifiers, and wearing wrap around glasses when outdoors. Treatment of the deficiency can be accomplished with a Vitamin A or multivitamin supplement or by eating foods rich in Vitamin A. Treatment with supplements and/or diet can be successful until the disease progresses as far as corneal ulceration, at which point only an extreme surgery can offer a chance of returning sight.

References

^ Solans, R.; Bosch, J.A.; Galofre, P.; others (2001), "Salivary and lacrimal gland dysfunction (sicca syndrome) after radioiodine therapy.", Journal of Nuclear Medicine 42 (5): 738–43, PMID 11337569

External links

664403984 at GPnotebook
WebMD
Xerophthalmia Causes

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1. ドライアイ dry eyes
2. シェーグレン症候群におけるドライアイの治療 treatment of dry eyes in sjogrens syndrome
3. ビタミンAの概要 overview of vitamin a
4. シェーグレン症候群の診断および分類 diagnosis and classification of sjogrens syndrome
5. シェーグレン症候群の臨床症状：外分泌腺障害 clinical manifestations of sjogrens syndrome exocrine gland disease

English Journal

Diffuse Cystic Lung Disease as the Presenting Manifestation of Sjögren's Syndrome.

Gupta N1, Wikenheiser-Brokamp KA2,3, Fischer A4, McCormack FX5.
Annals of the American Thoracic Society.Ann Am Thorac Soc.2016 Jan 7. [Epub ahead of print]
Interstitial lung diseases, especially lymphoproliferative disorders such as follicular bronchiolitis and lymphoid interstitial pneumonia, are commonly seen in association with Sjögren's syndrome. While the predominant computed tomographic (CT) findings in patients with lymphoid interstitial pneumo
PMID 26741500

Sodium hyaluronate's effect on xerophthalmia: a meta-analysis of randomized controlled trials.

Kong X1, Yan C1, Ma W1, Li Y1, Xing B1, Yang Y1, Wang R1.
Current medical research and opinion.Curr Med Res Opin.2016 Jan 7:1-8. [Epub ahead of print]
BACKGROUND AND AIMS: Several studies in the past have attempted to demonstrate the efficacy of sodium hyaluronate in the treatment of xerophthalmia. However, results have been conflicting and a definite conclusion has not yet been reached. In order to provide integrated evidence for the effectivenes
PMID 26613131

The Appropriate Surgical Approach to a Greater Petrosal Nerve Schwannoma in the Setting of Temporal Lobe Edema.

Kusumi M1, Oka H2, Aliabadi H3, Sato S2, Kumabe T2.
World neurosurgery.World Neurosurg.2016 Jan;85:364.e5-364.e10. doi: 10.1016/j.wneu.2015.08.048. Epub 2015 Sep 2.
BACKGROUND: Facial nerve schwannomas are rare lesions that constitute only 0.8% of all intrapetrous mass lesions. The least frequent lesions are tumors originating in the greater petrosal nerve (GPN). We present a case of a GPN schwannoma with temporal lobe edema in which the patient was operated on
PMID 26341443

Japanese Journal

臨床報告ビタミンA欠乏症に伴い,両眼眼球乾燥症をきたした1例

山本聡一郎,中尾功,平田憲 [他]
眼科 55(12), 1543-1547, 2013-11
NAID 40019874992

下鼻甲介手術を併施した後鼻神経切断術の有効性の検討

上條篤,黒田優美,初鹿恭介 [他],森山元大,松岡伴和,山本卓典,加瀬康弘,増山敬祐
アレルギー 62(1), 47-53, 2013-01-30
【背景】ヴィディアン神経切断術は血管運動性鼻炎や難治性通年性アレルギー性鼻炎に有効であるが,一方で,ドライアイや三叉神経痛などの合併症の問題からほとんど施行されなくなった.これに代わり,内視鏡下に後鼻神経を切断する術式が開発され,最近では一般的になりつつある.今回,当科で後鼻神経切断術を行った症例にアンケート調査を施行し,当手術の妥当性,反省点を明らかにすべく検討を試みた.【対象と方法】2005年 …
NAID 110009580191

Multiple cranial nerve enhancement on MRI in primary Sjﾃｶgren's syndrome

Sakai Kenji,Hamaguchi Tsuyoshi,Yamada Masahito
Internal Medicine 49(9), 857-859, 2010
… He had xerophthalmia and xerostomia. …
NAID 130000251886

Related Pictures

Xerophthalmia The gallery for --> Xerophthalmia Xerophthalmia - Symptoms, Causes, Treatment, Pictures Profound xerophthalmia due to vitamin A deficiency. EyeRounds.org: Online Ophthalmic Atlas

★リンクテーブル★

リンク元	「眼球乾燥」「眼球乾燥症」

「眼球乾燥」

Xerophthalmia
Classification and external resources
Specialty	endocrinology
ICD-10	E50.6-E50.7
ICD-9-CM	264.6-264.7
DiseasesDB	34035
MedlinePlus	000426
Patient UK	Xerophthalmia
MeSH	D014985

　　[★]

英: xerophthalmia
関: 眼球乾燥症

「眼球乾燥症」

　　[★]

英: xerophthalmia
関: [[]]

[Solansetal.2001-1] Solans, R.; Bosch, J.A.; Galofre, P.; others (2001), "Salivary and lacrimal gland dysfunction (sicca syndrome) after radioiodine therapy.", Journal of Nuclear Medicine 42 (5): 738–43, PMID 11337569

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xerophthalmia