Yu Michael D, Park Ji Kwan, Kossler Andrea L
Oculoplastic Surgery and Orbital Oncology Service, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Oculofacial Plastic and Orbital Surgery, Indianapolis, IN, USA.
Clin Ophthalmol. 2021 Oct 20;15:4219-4226. doi: 10.2147/OPTH.S284622. eCollection 2021.
Dry eye disease (DED) affects up to one-third of the global population. Traditional therapies, including topical lubricants, have been employed with variable success in the treatment of DED. Recently, neurostimulation of the lacrimal functional unit (LFU) has emerged as a promising alternative therapy for DED. In this review, we describe the neuroanatomical and pathophysiological considerations of DED and the LFU that make neurostimulation a viable therapeutic alternative. We further detail the various neurostimulatory approaches taken thus far-from implanted stimulators to external devices to chemical neurostimulation. Existing studies reveal the strengths of the neurostimulatory approach in increasing tear volume and improving dry eye symptoms, but further studies are needed to elucidate its true potential in treatment of DED.
干眼病(DED)影响着全球多达三分之一的人口。包括局部润滑剂在内的传统疗法在治疗干眼病方面取得的成效不一。最近,对泪液功能单位(LFU)进行神经刺激已成为一种有前景的干眼病替代疗法。在本综述中,我们描述了干眼病和泪液功能单位的神经解剖学及病理生理学因素,这些因素使神经刺激成为一种可行的治疗选择。我们进一步详细介绍了迄今为止所采用的各种神经刺激方法——从植入式刺激器到外部设备再到化学神经刺激。现有研究揭示了神经刺激方法在增加泪液量和改善干眼症状方面的优势,但仍需进一步研究以阐明其在治疗干眼病方面的真正潜力。