Department of Ophthalmology and Epidemiology, University of Groningen, University Medical Centre Groningen, The Netherlands.
Department of Ophthalmology, Oslo University Hospital, Oslo, Norway.
Clin Exp Rheumatol. 2020 Jul-Aug;38 Suppl 126(4):301-309. Epub 2020 Sep 25.
Primary Sjögren's syndrome is a complex systemic autoimmune disorder that primarily affects exocrine glands such as the lacrimal glands. Dry eye disease is one of the most prevalent complications of Sjögren's syndrome, affecting most patients. It significantly impairs quality of life and management is often difficult and unsatisfactory, in part due to weak correlation between symptoms and signs and poor recognition of the three main subtypes aqueous-deficient, evaporative and neuropathic dry eye. This review provides an overview of key aspects of dry eye disease, such as its multifactorial aetiology and recent insights into pathophysiology. The uses and pitfalls of commonly-used diagnostic tests for dry eye are reviewed, as well as the increasing number of new imaging technologies and biomarkers to refine diagnosis. There are many current and emerging treatment options for dry eye in Sjögren's syndrome, but high-level evidence of efficacy is mostly lacking, as are evidence-based treatment algorithms. All these aspects make the management of dry eye in Sjögren's syndrome challenging.
原发性干燥综合征是一种复杂的系统性自身免疫性疾病，主要影响泪腺等外分泌腺。干燥性眼病是干燥综合征最常见的并发症之一，影响大多数患者。它显著降低了生活质量，而管理通常很困难且不满意，部分原因是症状和体征之间的相关性较弱，以及对三种主要亚型（水缺乏型、蒸发型和神经病变型）干燥眼的认识不足。这篇综述提供了干燥性眼病的关键方面的概述，例如其多因素发病机制和最近对病理生理学的了解。还回顾了常用的干燥性眼病诊断测试的用途和陷阱，以及越来越多的新型成像技术和生物标志物来改善诊断。在干燥综合征中，有许多当前和新兴的干燥眼病治疗选择，但大多数缺乏疗效的高级别证据，也缺乏基于证据的治疗算法。所有这些方面都使干燥综合征中干燥眼病的管理具有挑战性。
