Pflugfelder S C
Ocular Surface and Tear Center, Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida 33136, USA.
Adv Dent Res. 1996 Apr;10(1):9-12. doi: 10.1177/08959374960100011801.
The pre-ocular tear film is a complex biochemical structure produced by the lacrimal glands and epithelial cells on the ocular surface. Clinical syndromes of ocular irritation may result from deficiencies in one or more of these layers. At a recent dry eye workshop at the National Eye Institute, dry eye conditions were classified into those with adequate aqueous tear production and those with aqueous tear deficiency. The majority of patients with aqueous adequate dry eye suffer from meibomian gland dysfunction that results in lipid tear deficiency. Aqueous tear deficiency can be subclassified into non-Sjögren's syndrome and Sjögren's syndrome (SS) groups. Patients with non-Sjögren's aqueous tear deficiency have less-severe symptoms and ocular surface disease than those with SS. The etiology of non-Sjögren's aqueous tear deficiency has not been established, but it appears to be multifactorial. In SS, immune-mediated destruction of the lacrimal gland results in severe aqueous tear deficiency. Aqueous tear deficiencies lead to ocular surface disease, termed keratoconjunctivitis sicca (KCS). KCS results from abnormal terminal differentiation of the ocular surface epithelia and is associated with marked reduction in mucin production by these cells. Clinical features helpful in differentiating the various dry eye syndromes are reviewed.
眼前泪膜是一种由泪腺和眼表上皮细胞产生的复杂生化结构。眼刺激的临床综合征可能由这些层中的一层或多层缺乏引起。在国家眼科研究所最近举办的一次干眼研讨会上，干眼状况被分为泪液分泌充足型和泪液分泌不足型。大多数泪液分泌充足型干眼患者患有睑板腺功能障碍，导致脂质泪液缺乏。泪液分泌不足可细分为非干燥综合征和干燥综合征（SS）组。非干燥综合征性泪液分泌不足患者的症状和眼表疾病比干燥综合征患者轻。非干燥综合征性泪液分泌不足的病因尚未明确，但似乎是多因素的。在干燥综合征中，泪腺的免疫介导性破坏导致严重的泪液分泌不足。泪液分泌不足会导致眼表疾病，称为角结膜干燥症（KCS）。KCS是由眼表上皮细胞异常终末分化引起的，与这些细胞粘蛋白产生的显著减少有关。本文综述了有助于区分各种干眼综合征的临床特征。
