《欧洲干眼专家组干眼炎症控制治疗推荐》解读

Interpretation of Management of inflammation in dry eye disease:recommendations from a European panel of experts

干眼是目前影响视觉与生活质量最常见的眼表疾病之一。国际干眼工作组报告中建议尽早使用局部糖皮质激素或/和环孢素A进行抗炎治疗。然而,目前在临床诊疗中应该何时使用、如何使用局部环孢素A和糖皮质激素治疗干眼,尚缺少的相关指导内容。欧洲干眼专家组通过问卷调查的方式就干眼疾病严重程度和进展、干眼患者的管理、环孢素的疗效、安全性和耐受性以及患者教育达成共识,并提出了糖皮质激素和环孢素A治疗干眼的具体治疗方案。目前我国开展大规模干眼抗炎治疗的时间较短,相关经验有限。为此,本文结合欧洲干眼专家组抗炎共识的内容及其相关文献,从炎症在干眼疾病发展中的作用、干眼患者的炎症表现方面阐述干眼抗炎治疗的必要性,并汇总分析干眼抗炎药物的使用方法,以期指导我国临床诊疗中干眼的抗炎治疗。

Dry eye disease(DED)is a common ocular surface disease with significant impact on vision and quality of life.Early anti-inflammatory therapy with topical glucocorticoids and/or cyclosporine A(CsA)is recommended by the Tear Film&Ocular Surface Society Dry Eye Workshop(TFOS DEWS)Ⅱreport.Currently,there is no clear guidance on several aspects of the use of glucocorticoids and CsA in the management of DED,such as when and how to start therapy.Therefore,a European panel of dry eye experts developed a consensus through a questionnaire covering disease and progression,patient management,efficacy,safety and tolerability of CsA,patient education and criteria that are easy to apply in the clinic,and proposed specific treatment protocols for glucocorticoids and CsA in the treatment of DED.China has just started anti-inflammatory therapy for DED with little information to guide clinical practice.Hence,combining the consensus and relevant literature,this article interprets the role of inflammation in the development of DED,the inflammatory manifestations of DED and the anti-inflammatory therapy to guide the ophthalmologists in clinical practice.