Johnson Michael E, Murphy Paul J
School of Optometry and Vision Sciences, Cardiff University, King Edward VII Avenue, Cardiff CF10 3NB, UK.
Prog Retin Eye Res. 2004 Jul;23(4):449-74. doi: 10.1016/j.preteyeres.2004.04.003.
Dry eye syndrome (DES) refers to a spectrum of ocular surface diseases with diverse and frequently multiple aetiologies. The common feature of the various manifestations of DES is an abnormal tear film. Tear film abnormalities associated with DES are tear deficiency, owing to insufficient supply or excessive loss, and anomalous tear composition. These categorizations are artificial, as in reality both often coexist. DES disrupts the homeostasis of the tear film with its adjacent structures, and adversely affects its ability to perform essential functions such as supporting the ocular surface epithelium and preventing microbial invasion. In addition, whatever the initial trigger, moderate and severe DES is characterized by ocular surface inflammation, which in turn becomes the cause and consequence of cell damage, creating a self-perpetuating cycle of deterioration. Progress has been made in our understanding of the aetiology and pathogenesis of DES, and these advances have encouraged a proliferation of therapeutic options. This article aims to amalgamate prevailing ideas of DES development, and to assist in that, relevant aspects of the structure, function, and production of the tear film are reviewed. Additionally, a synopsis of therapeutic strategies for DES is presented, detailing treatments currently available, and those in development.
干眼综合征（DES）指的是一系列眼表疾病，其病因多样且常常是多因素的。DES各种表现的共同特征是泪膜异常。与DES相关的泪膜异常包括由于供应不足或过度流失导致的泪液缺乏，以及泪液成分异常。这些分类是人为的，因为实际上两者常常并存。DES破坏了泪膜及其相邻结构的稳态，并对其执行诸如支持眼表上皮和防止微生物入侵等基本功能的能力产生不利影响。此外，无论最初的触发因素是什么，中度和重度DES的特征是眼表炎症，而炎症反过来又成为细胞损伤的原因和结果，形成一个自我持续恶化的循环。我们对DES的病因和发病机制的理解取得了进展，这些进展促进了治疗选择的增加。本文旨在整合关于DES发展的主流观点，并为此对泪膜的结构、功能和产生的相关方面进行综述。此外，还介绍了DES的治疗策略概要，详细说明了目前可用的治疗方法以及正在研发的治疗方法。
