从临床角度定义干眼症。
Defining Dry Eye from a Clinical Perspective.
机构信息
Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan.
Department of Ophthalmology, Baylor College of Medicine, Houston, TX 77030, USA.
出版信息
Int J Mol Sci. 2020 Dec 4;21(23):9271. doi: 10.3390/ijms21239271.
Over the past decades, the number of patients with dry eye disease (DED) has increased dramatically. The incidence of DED is higher in Asia than in Europe and North America, suggesting the involvement of cultural or racial factors in DED etiology. Although many definitions of DED have been used, discrepancies exist between the various definitions of dry eye disease (DED) used across the globe. This article presents a clinical consensus on the definition of DED, as formulated in four meetings with global DED experts. The proposed new definition is as follows: "Dry eye is a multifactorial disease characterized by a persistently unstable and/or deficient tear film (TF) causing discomfort and/or visual impairment, accompanied by variable degrees of ocular surface epitheliopathy, inflammation and neurosensory abnormalities." The key criteria for the diagnosis of DED are unstable TF, inflammation, ocular discomfort and visual impairment. This definition also recommends the assessment of ocular surface epitheliopathy and neurosensory abnormalities in each patient with suspected DED. It is easily applicable in clinical practice and should help practitioners diagnose DED consistently. This consensus definition of DED should also help to guide research and clinical trials that, to date, have been hampered by the lack of an established surrogate endpoint.
在过去的几十年中,干眼症(DED)患者的数量急剧增加。DED 的发病率在亚洲高于欧洲和北美,这表明 DED 的病因涉及文化或种族因素。尽管已经使用了许多 DED 的定义,但全球范围内使用的各种 DED 定义之间存在差异。本文提出了一个关于 DED 定义的临床共识,该共识是在与全球 DED 专家进行的四次会议中制定的。提出的新定义如下:“干眼症是一种多因素疾病,其特征是持续不稳定和/或不足的泪膜(TF)导致不适和/或视力障碍,伴有不同程度的眼表上皮病变、炎症和神经感觉异常。”DED 的诊断关键标准是不稳定的 TF、炎症、眼部不适和视力障碍。该定义还建议在每个疑似 DED 患者中评估眼表上皮病变和神经感觉异常。它在临床实践中易于应用,应该有助于医生一致地诊断 DED。DED 的这一共识定义也应该有助于指导研究和临床试验,迄今为止,由于缺乏既定的替代终点,这些研究和临床试验一直受到阻碍。