Jarka Edward S, Kahrhoff Mark, Crane John B
Universityof Missouri-St. Louis College of Optometry, One University Blvd., St. Louis, MO 63121-4400, USA.
Optometry. 2012 Mar 30;83(3):111-3.
Dry eye syndrome (DES) has been described by The International Dry Eye WorkShop as ''multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance and tear instability with potential damage to the ocular surface.'' Inflammation has been recognized as a primary contributor to the disease and was a tremendous step forward in the description and treatment of DES. Although most treatments of DES treat inflammation, the signs and symptoms of DES usually return shortly after discontinuing the use of the anti-inflammatory agent;
We present a case of a 70-year-old patient who presents with significant dry eye symptoms for 2 years. She reports the need to wear sunglasses during all waking hours, both indoors and out, and had discontinued her hobby of gardening. She had ocular rosacea diagnosed at a previous ophthalmology practice and did not respond to any past treatments. The patient was treated with 25% platelet-rich plasma (PRP) and experienced significant improvement and a return to a normal quality of life that has continued for more than a year after discontinuing treatment;
Our group is investigating the use of biologic therapeutics in the treatment of various forms of DES. We suggest that a clinically acceptable dosage of PRP provides the ocular surface with the components necessary to restore normal cellular tensegrity and provides a foundation to eliminate the recurrence of the inflammation associated with DES.
国际干眼研讨会将干眼综合征(DES)描述为“一种泪液和眼表的多因素疾病,可导致不适症状、视觉障碍和泪液不稳定,并可能对眼表造成损害”。炎症已被认为是该疾病的主要促成因素,这在DES的描述和治疗方面是一个巨大的进步。尽管大多数DES治疗方法都针对炎症,但停用抗炎药后,DES的体征和症状通常很快就会复发。
我们报告一例70岁患者,有2年严重干眼症状。她表示无论在室内还是室外,醒着的所有时间都需要戴太阳镜,并且已经放弃了园艺爱好。她曾在之前的眼科诊所被诊断为眼部酒渣鼻,对以往任何治疗均无反应。该患者接受了25%富血小板血浆(PRP)治疗,症状显著改善,恢复了正常生活质量,停止治疗后这种状态持续了一年多。
我们的团队正在研究生物疗法在各种形式的DES治疗中的应用。我们认为,临床上可接受剂量的PRP为眼表提供了恢复正常细胞张力完整性所需的成分,并为消除与DES相关的炎症复发奠定了基础。