Sherwin Justin C, Kokavec Jan, Thornton Simon N
Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
Lions Eye Institute, University of Western Australia, Centre for Ophthalmology and Visual Science, Perth, Western Australia, Australia.
Clin Exp Ophthalmol. 2015 Nov;43(8):749-64. doi: 10.1111/ceo.12546. Epub 2015 Jun 19.
Variation in systemic hydration status, namely chronic systemic hypohydration or dehydration, can influence the development of several chronic non-ophthalmic diseases. Owing to the eye's high water content and unique system of fluid regulation, we hypothesized that hydration status may affect the eye in health and disease states. Therefore, we performed a systematic review of the current evidence implicating changes in hydration and their association with ocular physiology and morphological characteristics. We also reviewed relevant clinical correlations of changes in hydration and major common eye diseases. Our findings suggest that systemic hydration status broadly affects a variety of ocular pathophysiologic processes and disease states. For example, dehydration may be associated with development of dry eye syndrome, cataract, refractive changes and retinal vascular disease. On the other hand, excessive hydration is associated with some ocular diseases. Tear fluid osmolarity may be an effective marker of systemic hydration status. Recent studies implicate chronic renin-angiotensin-aldosterone system activation in the pathogenesis of diabetic retinopathy and glaucoma but also suggest its antagonism may be a useful therapeutic target. Our findings indicate that assessment of hydration status may be an important consideration in the management of patients with chronic eye diseases and undergoing eye surgery. Further research investigating the role of acute and chronic changes in hydration in individuals with and without ocular disease is warranted.
全身水合状态的变化，即慢性全身水合不足或脱水，可影响多种慢性非眼科疾病的发展。由于眼睛的高含水量和独特的液体调节系统，我们推测水合状态可能在健康和疾病状态下影响眼睛。因此，我们对目前有关水合变化及其与眼生理和形态特征关联的证据进行了系统综述。我们还回顾了水合变化与主要常见眼病的相关临床关联。我们的研究结果表明，全身水合状态广泛影响多种眼部病理生理过程和疾病状态。例如，脱水可能与干眼症、白内障、屈光变化和视网膜血管疾病的发生有关。另一方面，水合过多与一些眼部疾病有关。泪液渗透压可能是全身水合状态的有效标志物。最近的研究表明，慢性肾素-血管紧张素-醛固酮系统激活在糖尿病视网膜病变和青光眼的发病机制中起作用，但也表明其拮抗作用可能是一个有用的治疗靶点。我们的研究结果表明，评估水合状态可能是慢性眼病患者和接受眼科手术患者管理中的一个重要考虑因素。有必要进一步研究水合的急性和慢性变化在有或没有眼病的个体中的作用。
