Foulks Gary N
Arthur and Virginia Keeney Professor of Ophthalmology, Department of Ophthalmology and Vision Science, University of Louisville School of Medicine, Louisville, Kentucky 40202, USA.
Drugs Aging. 2008;25(2):105-18. doi: 10.2165/00002512-200825020-00003.
Dry eye disease is a common and increasingly prevalent condition particularly associated with advancing age and postmenopausal women. Epidemiological studies identify prevalence rates ranging from 7% in the US to 33% in the Asian population. Research increasingly identifies risk factors of increasing age, female sex, smoking, use of video display terminals and use of certain medications as well as environmental stresses as aggravating factors for the disease. Basic and clinical investigations provide cumulative evidence of hyperosmolarity of the tear film and ocular surface/lacrimal gland inflammation as pathogenic features of dry eye disease. A decline in systemic and local levels of sex hormones is associated with advancing age and advancing disease. Pharmacological therapeutic interventions include enhanced lubricants and anti-inflammatory drugs such as topical corticosteroids and ciclosporin (cyclosporine A). Secretagogues and hormonal supplementation are potential future therapies. The increased understanding of the contributing and pathogenetic factors responsible for dry eye provides a rationale for multiple therapeutic options for this multi-factorial disease. In the elderly patient it is important to recognize the physical and cognitive limitations that will influence the selection of appropriate topical medication.
干眼疾病是一种常见且日益普遍的病症，尤其与年龄增长及绝经后女性相关。流行病学研究表明，患病率在美国为7%，在亚洲人群中为33%。研究越来越多地确定年龄增长、女性性别、吸烟、使用视频显示终端、使用某些药物以及环境压力等风险因素是该疾病的加重因素。基础和临床研究提供了累积证据，表明泪膜高渗以及眼表/泪腺炎症是干眼疾病的致病特征。随着年龄增长和疾病进展，性激素的全身和局部水平会下降。药物治疗干预措施包括增强润滑剂和抗炎药物，如局部用皮质类固醇和环孢素（环孢菌素A）。促分泌剂和激素补充是未来潜在的治疗方法。对导致干眼的促成因素和致病因素的深入了解为这种多因素疾病的多种治疗选择提供了理论依据。对于老年患者，认识到会影响适当局部用药选择的身体和认知限制非常重要。
