糖尿病相关干眼的研究进展

Research progress on dry eye in diabetes mellitus

糖尿病在全世界发病率普遍增高,糖尿病可引起干眼、角膜病、糖尿病视网膜病变、青光眼、白内障、屈光异常改变等一系列眼部并发症,严重影响视力甚至失明.近些年糖尿病对眼表造成损害正逐渐引起临床医师关注,糖尿病相关干眼主要表现为角膜上皮反复剥脱、上皮再生延迟、角膜敏感性下降等,这主要与糖尿病条件下泪液异常、泪液渗透压升高、泪膜稳定性差、角膜神经退行性改变等异常有关.现将糖尿病相关干眼的主要临床特点结合泪液变化、角膜神经敏感性变化、血糖水平、病程、降糖药物等相关影响因素以及特殊诊断方法和治疗策略等方面的进展进行总结,为临床诊断和治疗提供理论依据.

The incidence of diabetes mellitus has generally increased all over the world.Diabetes mellitus causes several complications,including dry eye,diabetic keratopathy,diabetic retinopathy,glaucoma,cataract,and ametropia,which seriously decrease visual acuity and even cause blindness.The correlation of diabetes mellitus and ocular surface complications is significantly elevated.Dry eye in diabetes mellitus mainly exhibits several clinical features that include recurring corneal epithelial exfoliation,the delay of corneal epithelial regeneration,and a decrease in corneal sensitivity.These anomolies are mainly caused by changes in tears,increasing tear film osmolarity,unstable tear film,and corneal nerve damage in hyperglycemic conditions.This paper briefly reviews research on the factors that influence dry eye in diabetes mellitus along with clinical features,and discusses new detection methods and treatment strategies.