国际眼科纵览 ›› 2020, Vol. 44 ›› Issue (5): 331-339.doi: 10.3760/ cma.j.issn.1673-5803.2020.05.007

• 综述 • 上一篇    下一篇

干眼的药物治疗

赵璐 潘志强   

  1. 首都医科大学附属北京同仁医院北京同仁眼科中心眼科学与视觉科学北京市重点实验室100730
  • 收稿日期:2020-02-25 出版日期:2020-10-22 发布日期:2020-11-01
  • 通讯作者: 潘志强,Email:panyj0526@sina.com

Drug therapy of dry eye

Zhao Lu, Pan Zhiqiang   

  1. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100730, China
  • Received:2020-02-25 Online:2020-10-22 Published:2020-11-01
  • Contact: Pan Zhiqiang, Email: panyj0526@sina.com

摘要:

干眼是一种常见的眼科疾病,病因众多,发病机制复杂,病情反复是其主要特点。既往认为泪液渗透压升高及眼表炎症是导致干眼的重要因素,最新的研究提出免疫反应及神经异常也参与了干眼的发病机制。随着对病因和发病机制的不断探索,相应的治疗方法也在不断完善。目前主要包括物理、药物、手术治疗,其中药物治疗占重要地位。根据病因和发病机制将治疗干眼的药物分为两大类。 其一增加泪液质量,改善泪膜稳定性:包括泪液替代治疗(补充水液成分、黏蛋白成分、脂质成分的人工泪液,以及维生素类制剂、自体血清等),促泌剂(促水液分泌剂以及促黏蛋白分泌剂)及omega-3脂肪酸补充剂;其二针对病因治疗,改善眼表微环境:包括糖皮质激素类滴眼液、非甾体类抗炎药、免疫抑制剂、黏附因子抑制剂、其他新型抗炎模式、抗生素、重建微生态平衡、抗氧化剂、神经保护剂等。(国际眼科纵览,2020, 44:331-339)

 

关键词: 干眼, 药物治疗

Abstract:

Dry eye is a multifactorial disease characterized by tear hyperosmotic and ocular surface inflammation. Complex pathogenesis and recurrent attacks are the main features of it. Recent studies have proposed that immune reaction and neurosensory abnormalities are also involved in its pathogenesis. With the continuous exploration of its etiology and pathogenesis, the treatment methods are also constantly improving. The traditional medical treatments consist of physical therapy, pharmaceutical and surgery, in which drug plays an important role.  According to etiology and pathogenesis of dry eye, the drugs of it are classified into two categories. One is to improve the quality and stability of tear film, including tear substitutes (such as autologous serum, vitamins and artificial tear complemented with aqueous solution, mucin and lipid), secretagogues (such as aqueous and mucous secretion stimulants) and omega-3 fatty acid supplements. Secondly, more effective, ophthalmic pharmacological drugs targeting various distinct etiology of dry eye have been investigated in improving the ocular surface microenvironment. The corresponding drugs include glucocorticoid eyedrops, non-steroidal anti-inflammatory drugs, immunosuppressants, adhesion factor inhibitors, other treatments in new anti-inflammatory models, antibiotics, reconstruction of microecological balance, antioxidants, neuroprotectants and so on.(Int Rev Ophthalmol, 2020, 44:331-339)

Key words: dry eye, drug treatment