Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA.
Am J Ophthalmol. 2011 Dec;152(6):900-909.e1. doi: 10.1016/j.ajo.2011.08.023. Epub 2011 Oct 22.
To describe the cause and consequence of tear dysfunction-related corneal disease.
Perspective on effects of tear dysfunction on the cornea.
Evidence is presented on the effects of tear dysfunction on corneal morphology, function, and health, as well as efficacy of therapies for tear dysfunction-related corneal disease.
Tear dysfunction is a prevalent eye disease and the most frequent cause for superficial corneal epithelial disease that results in corneal barrier disruption, an irregular optical surface, light scattering, optical aberrations, and exposure and sensitization of pain-sensing nerve endings (nociceptors). Tear dysfunction-related corneal disease causes irritation and visual symptoms such as photophobia and blurred and fluctuating vision that may decrease quality of life. Dysfunction of 1 or more components of the lacrimal functional unit results in changes in tear composition, including elevated osmolarity and increased concentrations of matrix metalloproteinases, inflammatory cytokines, and chemokines. These tear compositional changes promote disruption of tight junctions, alter differentiation, and accelerate death of corneal epithelial cells.
Corneal epithelial disease resulting from tear dysfunction causes eye irritation and decreases visual function. Clinical and basic research has improved understanding of the pathogenesis of tear dysfunction-related corneal epithelial disease, as well as treatment outcomes.
描述泪液功能障碍相关角膜疾病的病因和后果。
着眼于泪液功能障碍对角膜的影响。
阐述了泪液功能障碍对角膜形态、功能和健康的影响，以及治疗泪液功能障碍相关角膜疾病的疗效。
泪液功能障碍是一种常见的眼部疾病，也是导致浅层角膜上皮疾病的最常见原因，后者可导致角膜屏障破坏、光学表面不规则、光散射、光学像差以及疼痛感受器（伤害感受器）暴露和致敏。泪液功能障碍相关角膜疾病可引起眼部刺激和视觉症状，如畏光、视力模糊和波动，从而降低生活质量。泪液功能单位的 1 个或多个成分功能障碍会导致泪液成分发生变化，包括渗透压升高和基质金属蛋白酶、炎症细胞因子和趋化因子浓度增加。这些泪液成分的变化会促进紧密连接的破坏、改变分化并加速角膜上皮细胞的死亡。
泪液功能障碍引起的角膜上皮疾病会引起眼部刺激并降低视觉功能。临床和基础研究提高了对泪液功能障碍相关角膜上皮疾病发病机制和治疗效果的认识。
