佩戴眼镜可能降低眼周光化性角化病风险

北卡罗来纳州罗利市——根据一项大型多中心临床试验的结果，佩戴眼镜与眼周皮肤光化性角化病(AK)发生率显著降低相关。

这项研究名为退伍军人事务部外用视黄酸化学预防试验(VATTCT)。布朗大学皮肤科的Kachiu C. Lee博士介绍，在每6个月1次、平均4年的前瞻性随访期间，1,131例老年受试者(其中多数为男性)中发生3,291例次眼周AK。不经常佩戴眼镜者的眼周AK发生率较经常佩戴眼镜者高出40%。这与眼科文献中报告的眼镜可减少滤过到眼周区域的紫外线辐射的理论是一致的。

研究者还猜测，佩戴眼镜者眼周非黑色素瘤皮肤癌发生率也可能较低。但研究未能证实这一假设，可能原因为眼周恶性肿瘤发生例数太少。尽管对所有可疑皮肤癌进行了活检，并给出组织病理学诊断，随访期间仅发生19例眼周鳞状细胞癌和71例眼周基底细胞癌。

眼镜可减少滤过到眼周区域的紫外线辐射。

该研究的主要局限性在于，未对太阳镜的使用情况进行调查。“这是一个重要的潜在混淆因素。”

该研究由美国退伍军人事务部资助。Lee博士披露无相关利益冲突。

爱思唯尔  版权所有

By: BRUCE JANCIN, Internal Medicine News Digital Network

RALEIGH, N.C. – Wearing glasses was associated with a significantly lower rate of developing actinic keratoses on periocular skin, according to the results of a large multicenter clinical trial.

During an average 4-year prospective follow-up conducted at 6-month intervals in the Veterans Affairs Topical Tretinoin Chemoprevention Trial, the 1,131 elderly participants, most of whom were male, developed 3,291 periocular actinic keratoses.
 
Patients who didn’t regularly wear eyeglasses had a 40% higher rate of developing AKs on periocular skin. This is consistent with reports in the ophthalmologic literature that eyeglasses can reduce the flux of UV radiation filtered to the periocular area, according to Dr. Kachiu C. Lee, a dermatology resident at Brown University in Providence, R.I.

Her hypothesis was that eyeglasses wearers would also have a lower rate of periocular nonmelanoma skin cancer. However, this wasn’t borne out, possibly because too few of the malignancies occurred to be able to demonstrate a protective effect, she noted. Although all suspected skin cancers were biopsied for histologic diagnosis, only 19 periocular squamous cell carcinomas and 71 periocular basal cell carcinomas occurred during follow-up.

A significant study limitation was that patients weren’t surveyed as to their use of sunglasses. "That’s a huge potential confounding variable," Dr. Lee said.

The study was sponsored by the U.S. Department of Veterans Affairs. Dr. Lee reported having no financial conflicts.