甲状腺相关眼病眼表损伤的研究进展

Research progress of ocular surface injury in thyroid-associated ophthalmopathy

甲状腺相关眼病是一种器官特异性自身免疫性疾病,其发病机制复杂,是成人最常见的眼眶疾病,且发病率逐年升高。该病不仅会导致眼球突出、眼睑退缩、睑裂扩大、眼球运动障碍等外观上的变化,且患者往往伴发眼红、眼痛、干涩、异物感、复视、视力下降等不适症状,其中眼表疾病的发病率较正常人明显增高,但其具体发病机制尚待进一步挖掘。目前研究表明甲状腺相关眼病患者的眼表损伤主要与眼表暴露增加、炎症侵犯、激素改变有关。角膜、结膜、泪膜、睑板腺等组织受累发生病理改变是患者表现出不同临床症状的直接原因。文章通过分析近年来国内外关于甲状腺相关眼病与眼表疾病等方面的相关研究,针对甲状腺相关眼病眼表损伤的病理改变及机制研究进展做一综述。

Thyroid-associated ophthalmopathy is an organ-specific autoimmune disease with complex pathogenesis.It is the most common orbital disease in adults,and its incidence increases year by year.This disease can not only lead to appearance changes such as eyeball protrusion,eyelid retraction,eyelid cleat enlargement,eye movement disorders,and patients are often accompanied by red eyes,eye pain,dryness,foreign body sensation,diplopia,vision loss and other uncomfortable symptoms,among which the incidence of ocular surface diseases is significantly higher than that of normal people,but its specific pathogenesis needs to be further explored.Current studies have shown that ocular surface injury in patients with thyroid-associated ophthalmopathy is mainly related to increased ocular surface exposure,inflammatory invasion,and hormonal changes.The pathological changes of cornea,conjunctiva,tear film,meibomian gland and other tissues involved are the direct causes of different clinical symptoms of patients.In this paper,through the analysis of recent domestic and foreign studies on thyroid-associated ophthalmopathy and ocular surface diseases,the pathological changes and mechanism of ocular surface injury in thyroid-associated ophthalmopathy were reviewed.