Shahraki Toktam, Baradaran-Rafii Alireza, Ayyala Ramesh, Arabi Amir, Jarstad John, Memar Fatemeh
Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, No. 23, Paidarfard St., Boostan 9 St., Pasdaran Ave, Tehran, Iran.
Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA.
Int Ophthalmol. 2024 Feb 9;44(1):49. doi: 10.1007/s10792-024-02978-1.
Dry eye disease (DED) is a prevalent ocular surface disease that is conventionally characterized by tear film hyperosmolarity and instability. This review presents a summarized classification of DED, followed by a comprehensive discussion of the most recent topical and systemic medications and clinical recommendations for selecting the most appropriate option for each patient.
An extensive literature search was conducted on electronic databases, such as PubMed, Scopus, and Web of Science, using keywords including "dry eye syndrome," "ocular surface disease," "medical management," "artificial tears," "topical immunomodulators," and "meibomian gland dysfunction."
The underlying reasons for DED can range from insufficient aqueous tear production to increased tear evaporation. Recent literature has provided a more in-depth understanding of the pathophysiology of DED by examining the tear film's lipid, aqueous, and mucin layers. However, despite these advancements, medical management of patients with symptomatic DED has not fully reflected this modernized knowledge of its pathophysiology.
To develop a rationalized strategy for treating DED, it is crucial to have updated knowledge of therapeutic options, their mechanisms of actions, and indications based on the DED type and underlying causes.
干眼疾病(DED)是一种常见的眼表疾病,传统上以泪膜高渗和不稳定为特征。本综述介绍了干眼疾病的分类概述,随后全面讨论了最新的局部和全身用药以及为每位患者选择最合适治疗方案的临床建议。
在电子数据库(如PubMed、Scopus和Web of Science)上进行了广泛的文献检索,使用的关键词包括“干眼综合征”、“眼表疾病”、“药物治疗”、“人工泪液”、“局部免疫调节剂”和“睑板腺功能障碍”。
干眼疾病的潜在原因从泪液分泌不足到泪液蒸发增加不等。最近的文献通过研究泪膜的脂质层、水液层和黏液层,对干眼疾病的病理生理学有了更深入的了解。然而,尽管有这些进展,有症状的干眼疾病患者的药物治疗尚未充分反映对其病理生理学的这种现代化认识。
为制定合理的干眼疾病治疗策略,关键是要掌握基于干眼疾病类型和潜在病因的治疗选择、作用机制及适应症的最新知识。