Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Invest Ophthalmol Vis Sci. 2018 Nov 1;59(14):DES71-DES79. doi: 10.1167/iovs.17-23750.
I have reviewed available literature on dry eye related to Sjögren's syndrome (SS), non-Sjögren's syndrome (non-SS), and graft-versus-host disease (GVHD) to examine aqueous tear deficient dry eye as a subtype of dry eye. This section will focus on clinical studies regarding those subtypes of dry eye. I searched the PubMed database from 1990-2017 for discussion of clinical features, diagnostic criteria, and risk factors of SS, non-SS, and GVHD-related dry eye. In addition, therapeutic options for each subtype of dry eye are described. Although the clinical presentations of SS and chronic graft-versus-host disease (cGVHD) are similar, ocular surface fibrotic changes are characteristic of ocular GVHD but not SS- or non-SS-related dry eye. Recently, diagnostic criteria for each disease have been proposed and include the American College of Rheumatology/European League Against Rheumatism (ACR-EULAR) for SS and the International Chronic Ocular GVHD consensus criteria. Although there has been gradual progress, there are currently no specific therapies and few approved treatment options for these intractable diseases, including SS and GVHD. As judged by the findings, these subtypes of dry eye are different clinical entities from simple dry eye. Therefore, novel therapies, specific to these subtypes of dry eye, may be required in the future.
我查阅了与干燥综合征(SS)、非干燥综合征(非 SS)和移植物抗宿主病(GVHD)相关的干眼症文献,以探讨以水样液缺乏为特征的干眼症作为干眼症的一个亚型。本节将重点介绍关于这些干眼症亚型的临床研究。我在 PubMed 数据库中检索了 1990 年至 2017 年关于 SS、非 SS 和 GVHD 相关干眼症的临床特征、诊断标准和危险因素的讨论。此外,还描述了每种干眼症亚型的治疗选择。尽管 SS 和慢性移植物抗宿主病(cGVHD)的临床表现相似,但眼表纤维化改变是眼 GVHD 的特征,而不是 SS 或非 SS 相关干眼症的特征。最近,每种疾病的诊断标准都已提出,包括美国风湿病学会/欧洲抗风湿病联盟(ACR-EULAR)的干燥综合征和国际慢性眼GVHD 共识标准。尽管已经取得了逐步进展,但目前这些难治性疾病(包括 SS 和 GVHD)尚无特异性治疗方法,也很少有获得批准的治疗选择。根据这些发现,这些干眼症亚型是不同于单纯干眼症的临床实体。因此,未来可能需要针对这些干眼症亚型的新型治疗方法。