McCabe Erin, Narayanan Srihari
Pennsylvania College of Optometry at Salus University, Elkins Park, 19027, USA.
Optometry. 2009 Oct;80(10):555-66. doi: 10.1016/j.optm.2009.02.010.
The goal of this literature review is to discuss recent discoveries in the pathophysiology of dry eye and the subsequent evolution of diagnostic and management techniques. The mechanisms of various anti-inflammatory treatments are reviewed, and the efficacy of common pharmacologic agents is assessed. Anti-inflammatory therapy is evaluated in terms of its primary indications, target population, and utility within a clinical setting.
The Medline PubMed database and the World Wide Web were searched for current information regarding dry eye prevalence, pathogenesis, diagnosis, and management. After an analysis of the literature, major concepts were integrated to generate an updated portrayal of the status of dry eye syndrome.
Inflammation appears to play a key role in perpetuating and sustaining dry eye. Discoveries of inflammatory markers found within the corneal and conjunctival epithelium of dry eye patients have triggered recent advancements in therapy. Pharmacologic anti-inflammatory therapy for dry eye includes 2 major categories: corticosteroids and immunomodulatory agents. Fatty acid and androgen supplementation and oral antibiotics have also shown promise in dry eye therapy because of their anti-inflammatory effects.
Anti-inflammatory pharmacologic agents have shown great success in patients with moderate to severe dry eye when compared with alternative treatment modalities. A deeper understanding of the link between inflammation and dry eye validates the utilization of anti-inflammatory therapy in everyday optometric practice.
本综述的目的是讨论干眼病理生理学的最新发现以及诊断和管理技术的后续发展。回顾了各种抗炎治疗的机制，并评估了常用药物的疗效。从主要适应证、目标人群及其在临床环境中的实用性方面对抗炎治疗进行了评估。
检索了Medline PubMed数据库和万维网，以获取有关干眼患病率、发病机制、诊断和管理的最新信息。在对文献进行分析后，整合主要概念以生成干眼综合征现状的最新描述。
炎症似乎在干眼的持续和维持中起关键作用。在干眼患者角膜和结膜上皮中发现的炎症标志物推动了近期治疗的进展。干眼的药物抗炎治疗包括两大类：皮质类固醇和免疫调节剂。脂肪酸和雄激素补充剂以及口服抗生素因其抗炎作用在干眼治疗中也显示出前景。
与其他治疗方式相比，抗炎药物在中重度干眼患者中取得了巨大成功。对炎症与干眼之间联系的更深入理解证实了抗炎治疗在日常验光实践中的应用价值。
