TFOS DEWS III摘要报告。

IF 4.2 1区 医学 Q1 OPHTHALMOLOGY
Fiona Stapleton, Pablo Argüeso, Penny Asbell, Dimitri Azar, Charles Bosworth, Wei Chen, Joseph Ciolino, Jennifer P Craig, Juana Gallar, Anat Galor, José A P Gomes, Isabelle Jalbert, Ying Jie, Lyndon Jones, Kenji Konomi, Yang Liu, Jesus Merayo-Lloves, Fabiola R Oliveira, Victor A Perez Quinones, Eduardo M Rocha, Benjamin D Sullivan, David A Sullivan, Jelle Vehof, Susan Vitale, Mark Willcox, James Wolffsohn, Murat Dogru
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引用次数: 0

摘要

本摘要总结了自2017年TFOS DEWS II报告以来发表的干眼病(DED)的跨学科研究。它包括七个主题,包括性、性别和激素、流行病学、病理生理学、泪膜、疼痛和感觉、医源性和临床试验设计,并探讨了这些如何为DED的诊断方法、疾病亚型和管理提供信息。由于激素、性染色体、性别特异性常染色体因子、表观遗传学、求医行为和服务利用,性别和性别相关差异显著影响眼表。流行病学数据显示,DED患病率因年龄和性别而异,受诊断标准和疾病多因素性质的影响。新的危险因素包括环境、医源性、全身性疾病和生活方式。水缺乏性干眼(ADDE)和蒸发性干眼(EDE)之间的病理生理区别已经明确。EDE的特点是眼表炎症反应减弱,睑板腺功能障碍,角膜上皮细胞可能发生表型改变。代谢、激素、生理、神经和细胞应激(包括高渗透压、线粒体应激和神经源性炎症)的作用越来越大。泪膜研究的进展为理解DED的发病机制和识别生物标志物(如microrna)提供了新的方法。眼痛觉与角膜神经的结构完整性、神经元的功能以及中枢和周围神经系统的活动有关。医源性DED可由药物、隐形眼镜和外科手术引起。临床试验现在强调将设计和终点与DED亚型和治疗机制相一致,并考虑新的治疗方法和试验设计。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
TFOS DEWS III Digest Report.

This digest summarises the interdisciplinary research in dry eye disease (DED) published since the 2017 TFOS DEWS II reports. It comprises seven topics including Sex, Gender, and Hormones, Epidemiology, Pathophysiology, Tear Film, Pain and Sensation, Iatrogenic and Clinical Trial Design and explores how each of these inform diagnostic methodology, disease subtype and management of DED. Sex- and gender-related differences significantly influence the ocular surface due to hormones, sex chromosomes, sex-specific autosomal factors, epigenetics, care-seeking behaviors, and service utilization. Epidemiological data reveal that DED prevalence varies by age and sex, influenced by diagnostic criteria and the multifactorial nature of the disease. New risk factors for DED include environmental, iatrogenic, systemic diseases and lifestyle domains. Pathophysiological distinctions between Aqueous Deficient Dry Eye (ADDE) and Evaporative Dry Eye (EDE) have been clarified. EDE is characterized by a muted inflammatory response at the ocular surface, meibomian gland dysfunction and conceivably phenotypic changes in corneal epithelial cells. There is an expanding role for metabolic, hormonal, physical, neural and cellular stresses, including hyperosmolarity, mitochondrial stress, and neurogenic inflammation. Advancements in tear film research recommend new approaches to understanding DED pathogenesis and identifying biomarkers, such as microRNAs. Ocular pain perception is linked to structural integrity of corneal nerves, functional capacities of neurons, and activity of the central and peripheral nervous systems. Iatrogenic DED can result from medications, contact lenses, and surgical procedures. Clinical trials now emphasize aligning design and endpoints with DED subtypes and therapeutic mechanisms, with new therapeutics and trial designs under consideration.

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来源期刊
CiteScore
9.20
自引率
7.10%
发文量
406
审稿时长
36 days
期刊介绍: The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.
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