糖尿病性干眼发病机制及治疗进展

Pathogenesis and advances in treatment of diabetic dry eye

糖尿病是一种主要以损害微血管为主的病变。随着生活水平的提高,糖尿病患者的数量也逐渐增加,据最新数据显示,全球的糖尿病患病率高达9.3%(4.63亿人)。糖尿病相关的视网膜病变是导致工作人群视力障碍最主要的原因,近年来人们逐渐认识到高糖也可以引起眼表泪膜的不稳定、角膜神经功能障碍、角膜感知功能下降、泪液渗透压升高。糖尿病引起的眼表功能障碍原因复杂,机制多样,包括高糖导致泪膜各层结构破坏、树突状细胞-神经沟通障碍、炎性因子破坏泪腺分泌泪液等。本文就糖尿病性相关干眼的发生机制、研究进展进行综述,以期眼科医师在诊疗糖尿病干眼患者时更多考虑全身情况。

Diabetes is a disease that leads primarily to microvascular damage.In recent years,with the improvement of living standards,the number of diabetes patients has been increasing.The latest data is shown that about 9.3%(463 million people)globally have diabetes.Diabetic retinopathy is a leading cause of visual impairment and blindness among the working-age population.What have been progressively recognized in recent years is hyperglycemia can also lead to tear film instability,corneal nerve dysfunction,corneal sensitivity decreased,and tear osmolarity increased.The etiology and mechanisms of ocular surface dysfunction caused by diabetes are diverse and complex,including hyperglycemia destabilizing the tear film,disturbances in connectivity between dendritic cells and neurons,and inflammatory cytokines inducing damage to the lacrimal glands,leading to impaired tear secretion.This article is intended to review recent progress and mechanisms in diabetic dry eye and the general conditions of patients that ophthalmologists should consider during the diagnosis and treatment of the diabetic dry eye.