我们的目的是证明口服维生素B1和甲钴胺治疗后干眼病(DED)患者角膜神经参数以及症状和体征的变化。在这项随机双盲对照试验中,DED患者被随机分配到治疗组(口服维生素B1和甲钴胺,人工泪液)或对照组(人工泪液)。通过体内共聚焦显微镜(IVCM)观察角膜神经参数,DED症状,和体征在基线和治疗后1个月和3个月进行评估.总的来说,纳入199例患者的398只眼。在治疗组中,角膜神经长度有显著改善,宽度,和神经瘤,结膜充血征象评分(CCS),干燥的症状,疼痛,畏光,视力模糊,总症状评分,治疗后1/3个月和OSDI(OSDI)(均p<0.05)。接受维生素B1和甲钴胺的患者在CCS中表现出更大的改善,1个月时的干燥评分(p&lt;0.05),角膜荧光素染色(CFS)(p=0.012),畏光(p=0.032),总症状评分(p=0.041),和OSDI(p=0.029)在3个月。CFS的持续改进(p=0.045),干燥度(p=0.033),治疗组患者在治疗后3个月表现为视力模糊(p=0.031)和总症状评分(p=0.023)。我们发现,口服维生素B1和甲钴胺可以改善角膜神经长度,宽度,IVCM中的反射率和神经瘤的数量,从而修复上皮细胞并缓解一些眼部症状。因此,维生素B1和甲钴胺是DED患者的潜在治疗选择.
Our purpose is to demonstrate the changes in cornea nerve parameters and symptoms and signs in dry eye disease (DED) patients after oral vitamin B1 and mecobalamin treatment. In this randomized double-blind controlled
trial, DED patients were randomly assigned to either the treatment group (oral vitamin B1 and mecobalamin, artificial tears) or the control group (artificial tears). Corneal nerve parameters via in vivo confocal microscopy (IVCM), DED symptoms, and signs were assessed at baseline and 1 and 3 months post-treatment. In total, 398 eyes from 199 patients were included. In the treatment group, there were significant improvements in corneal nerve length, width, and neuromas, the sign of conjunctival congestion score (CCS), symptoms of dryness, pain, photophobia, blurred vision, total symptom score, and OSDI (OSDI) at 1/3 months post-treatment (all p < 0.05). Patients who received vitamin B1 and mecobalamin showed greater improvement in CCS, dryness scores at 1 month (p < 0.05), corneal fluorescein staining (CFS) (p = 0.012), photophobia (p = 0.032), total symptom scores (p = 0.041), and OSDI (p = 0.029) at 3 months. Greater continuous improvement in CFS (p = 0.045), dryness (p = 0.033), blurred vision (p = 0.031) and total symptom scores (p = 0.023) was demonstrated at 3 months than at 1 month post-treatment in the treatment group. We found that oral vitamin B1 and mecobalamin can improve corneal nerve length, width, reflectivity and the number of neuromas in IVCM, thereby repairing epithelial cells and alleviating some ocular symptoms. Thus, vitamin B1 and mecobalamin are potential treatment options for patients with DED.