dry eye

干眼
  • 文章类型: Journal Article
    这项研究的目的是研究透明质酸钠(SH)联合普拉洛芬治疗干眼症患者的临床应用。
    纳入了2020年3月至2022年5月在昆山市中医医院治疗的117例干眼症患者。根据治疗方法,他们用SH治疗(SH组),普拉洛芬(普拉洛芬组),SH联合普拉洛芬(联合组)(n=39)。
    干眼的有效率为79.49%,SH组74.36%和94.87%,普拉洛芬组和联合组,分别为(p<0.05)。治疗后,联合组的泪液BUT和SIT均明显高于其他两组(p<0.05)。联合组治疗后角膜荧光素染色和干眼症状评分明显低于其他两组(p<0.001)。治疗后,视觉对比敏感度(12c/d,联合组18c/d和24c/d)明显高于其他两组(p<0.001)。CPR,TNF-α,联合组的IFN-γ和IL-1β水平明显低于其他两组(p<0.001)。治疗后,联合组的VRQOL生活质量评分明显高于其他两组(p<0.05)。
    SH联合普拉洛芬在治疗干眼方面显示出明显的治疗益处,疗效优于单独使用任何一种药物。
    UNASSIGNED: The aim of this study was to investigate the clinical use of sodium hyaluronate (SH) combined with pranoprofen in treating patients with dry eye.
    UNASSIGNED: A total of 117 patients with dry eye who were treated in the Traditional Chinese Medicine Hospital of Kunshan from March 2020 and May 2022 were included. According to the therapy approaches, they were treated with SH (SH group), pranoprofen (pranoprofen group), and SH combined with pranoprofen (joint group) (n = 39).
    UNASSIGNED: The effective rates of dry eye were 79.49%, 74.36% and 94.87% in the SH group, the pranoprofen group and the joint group, respectively (p < 0.05). After treatment, the tear BUT and SIT in the joint group were all prominently increased than those in the other two groups (p < 0.05). The corneal fluorescein staining and dry eye symptom scores in the joint group after treatment were dramatically lower than those in the other two groups (p < 0.001). After treatment, the visual contrast sensitivity (12 c/d, 18 c/d and 24 c/d) in the joint group was markedly higher than those in the other two groups (p < 0.001). The CPR, TNF-α, IFN-γ and IL-1β levels in the joint group were notably decreased than those in other two groups (p < 0.001). After treatment, the VRQOL quality-of-life scores in the joint group were significantly higher than those in the other two groups (p < 0.05).
    UNASSIGNED: SH combined with pranoprofen showed clear therapeutic benefit in treating dry eye, and the curative effect was more favorable than with either medication alone.
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  • 文章类型: Journal Article
    干眼影响全球大多数人口,导致严重的不适甚至视力障碍,其中炎症在恶化过程中起着至关重要的作用。这突出了需要有效和安全的抗炎治疗以实现令人满意的治疗结果。本研究的重点是四面体框架核酸(tFNA)的潜力,自组装的核酸材料,作为一种简单而快速的治疗干眼症相关的氧化应激和炎症引起的疾病。机械上,发现tFNA通过促进角膜上皮愈合有效缓解干眼损伤,恢复杯状细胞功能,促进泪液分泌恢复。通过RNA-seq分析,观察到tFNA处理使大多数基因的表达水平正常化。机制的进一步探索表明,tFNA减少了活性氧的过度产生,并调节了炎症微环境,特别是通过cGAS-STING途径,从而提高炎症细胞因子的水平,包括MMP9和IL-6降低。此外,tFNA表现出优异的安全性能而不会对眼睛造成损害。重要的是,这项研究代表了具有核酸生物学特征的纳米材料在干眼症的有效治疗中的成功应用,强调tFNA在干眼治疗中的潜在临床应用。
    Dry eye affects majority of the global population, causing significant discomfort or even visual impairment, of which inflammation plays a crucial role in the deterioration process. This highlights the need for effective and safe anti-inflammatory treatments to achieve satisfactory therapeutic outcomes. This study focuses on the potential of tetrahedral framework nucleic acids (tFNA), a self-assembled nucleic acid material, as a simple and rapid treatment for oxidative stress and inflammation-induced disorders associated with dry eye. Mechanistically, tFNA is found to effectively alleviate dry eye damage by promoting corneal epithelial healing, restoring goblet cell function, and facilitating tear secretion recovery. Through RNA-seq analysis, it is observed that tFNA treatment normalizes the expression levels of most genes. Further exploration of the mechanism reveals that tFNA reduces excessive production of reactive oxygen species and modulates the inflammatory microenvironment, especially through cGAS-STING pathway thereby levels of inflammatory cytokines, including MMP9 and IL-6, are reduced. Additionally, tFNA demonstrates excellent safety performance without causing damage to the eye. Importantly, this study represents a successful application of nanophase materials with nucleic acid biological features for the effective treatment of dry eye, highlighting the potential clinical use of tFNA in the treatment of dry eye.
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  • 文章类型: Journal Article
    这项研究的目的是评估强脉冲光(IPL)治疗在诊断为青光眼和干眼病(DED)的个体中的有效性。
    这项随机对照研究招募了22名诊断为青光眼的个体,年龄从33岁到82岁不等。这些参与者正在接受低血压滴眼液治疗,并具有与干眼相关的临床适应症和主观主诉。每位患者一只眼睛接受三次IPL治疗,而对侧眼作为对照眼(CT)。在三个时间点评估以下参数:基线,第2周和第4周。这些参数包括非侵入性破裂时间(NITBUT),撕裂弯月面高度(TMH),结膜角膜上皮染色评分(CS),泪膜脂质层(TFLL),睑板腺可表达性评分(MGEx),Schirmer我测试,眼眼球红肿评分(OBRS),眼表疾病指数(OSDI)。眼内压(IOP),最佳矫正视力(BCVA),和角膜内皮细胞计数(ECC)进行安全性评估。临床试验于2023年12月25日在ClinicalTrials.gov网站(NCT06158984)注册。
    比较基线和4周测量结果显示,IPL组发现NITBUT显着改善(IPL:8.74±2.60秒。与CT:5.76±1.75秒。p<0.01),TMH(IPL:0.23±0.05mmvs.CT:0.19±0.06mm,p=0.011),C.S.(IPL:1.14±0.56vsCT:1.95±1.17,p=0.005),TFLL(IPL:2.91±2.91vsCT:3.36±0.58,p=0.047),MGEX评分(IPL:1.14±0.35vsCT:1.45±0.51,p=0.020)和OSDI评分(IPL:31.77±15.59vs50.59±21.55,p=0.002)显着改善。相反,其他参数无显著改善(p>0.05).
    使用局部抗青光眼药物治疗的个体的眼表疾病的进展可能会恶化。然而,IPL治疗有可能导致干眼的客观和主观测量的显着改善。最佳矫正视力,内皮细胞计数,和眼压被确定在允许的范围内。在研究过程中没有报告不良事件。
    结果表明,使用局部药物治疗青光眼的人如果不治疗这个问题,可能会得到更严重的眼表疾病。IPL治疗,另一方面,在客观和主观干眼测试中都会有很大的不同。愿景,内皮细胞计数,IPL治疗后,眼内压力均在正常范围内。即使我们研究中的人患有青光眼,并且已经服用了一年的青光眼药物,而且症状持续很长时间的事实也可能会改变结果。此外,由青光眼药物引起的DED是复杂的,有很多不同的症状和体征,即使在同一阶段。此外,主观投诉可能与临床症状不符。类型,金额,抗青光眼药物的长度可能会影响结果。
    UNASSIGNED: The objective of this study was to assess the effectiveness of intense pulsed light (IPL) therapy in individuals diagnosed with glaucoma and dry eye disease (DED).
    UNASSIGNED: This randomized control study recruited 22 individuals diagnosed with glaucoma, ranging in age from 33 to 82 years. These participants were undergoing treatment with hypotensive eyedrops and had clinical indications and subjective complaints associated with dry eye. Each patient underwent three sessions of IPL therapy in one eye, while the contralateral eye served as the control eye (CT). The following parameters were assessed at three time points: baseline, week-2, and week-4. These parameters include non-invasive breakup time (NITBUT), tear meniscus height (TMH), conjunctivocorneal epithelial staining score (CS), tear film lipid layer (TFLL), meibomian gland expressibility score (MGEx), Schirmer I test, ocular bulbar redness score (OBRS), and ocular surface disease index (OSDI). Intraocular pressure (IOP), best-corrected visual acuity (BCVA), and corneal endothelial cell count (ECC) were assessed for safety. The clinical trial was registered on 25/12/2023 at ClinicalTrials.gov website (NCT06158984).
    UNASSIGNED: Comparing baseline and 4-week measurements revealed that the IPL group found significant improvements in NITBUT (IPL: 8.74±2.60 sec. vs CT: 5.76±1.75 sec. p<0.01), TMH (IPL: 0.23±0.05mm vs CT: 0.19±0.06mm, p=0.011), C.S. (IPL: 1.14±0.56 vs CT: 1.95±1.17, p=0.005), TFLL (IPL: 2.91±2.91 vs CT:3.36±0.58, p=0.047), MGEx score (IPL: 1.14±0.35 vs CT: 1.45±0.51, p=0.020) and OSDI scores (IPL: 31.77±15.59 vs 50.59±21.55, p=0.002) significantly improved. Conversely, other parameters showed no significant improvements (p>0.05).
    UNASSIGNED: The progression of ocular surface disease in individuals using topical anti-glaucoma medication may worsen if the condition is not addressed. Nevertheless, IPL therapy has the potential to result in significant improvements in both objective and subjective measures of dry eye. Best-corrected visual acuity, endothelial cell count, and intraocular pressure were determined to be within the permitted limits. No adverse events were reported during the course of the study.
    The results show that people who use topical medicines to treat glaucoma may get worse eye surface disease if they do not treat the problem. IPL treatment, on the other hand, can make a big difference in both objective and subjective dry eye tests. The vision, endothelial cell count, and the pressure inside the eye were all found to be within normal limits after the IPL treatment. Even though the people in our study had glaucoma and had been taking glaucoma medicine for it for a year and the fact that the symptoms last for a long time may also change the results. Also, DED caused by glaucoma medication is complicated, with a lot of different symptoms and signs, even in the same stage. Also, subjective complaints may not match up with clinical signs. The type, amount, and length of anti-glaucoma drugs may have affected the results.
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  • 文章类型: Journal Article
    目的:探讨不同程度近视患者眼表的临床特点。
    方法:于2月至6月在北京同仁医院进行了一项横断面研究,涉及122名近视患者,2023年。完成眼表疾病指数(OSDI)评分量表后,进行了折射测量,生物参数和眼表参数。患病率,根据眼轴长度(AL)比较不同组干眼的严重程度和相关参数。在眼表参数与屈光/生物测量参数之间进行相关性分析。
    结果:观察到屈光不正的统计学差异,角膜厚度,前房深度,各组间脉络膜厚度及中央凹下脉络膜厚度差异均有统计学意义(均P<0.05)。随着AL的增加,干眼的发生率和严重程度均显著增加(P<0.05)。此外,泪膜破裂时间(BUT)缩短(P<0.05),角膜荧光素染色(CFS)点明显增加(P<0.05)。OSDI评分与AL和球面当量呈正相关(SE;均P<0.05);BUT与AL呈负相关,SE,角膜散光(AST;均P<0.05);SchirmerI检验(SIT)结果与AL、SE呈负相关(均P<0.05)。
    结论:AL伸长是近视患者干眼发病的危险因素。AL越长,干眼症越严重,随着CFS斑点和泪膜不稳定性的增加。此外,SE和AST与干眼症状评分和眼表参数呈负相关。
    OBJECTIVE: To investigate the clinical features of the ocular surface in patients with different degrees of myopia.
    METHODS: A cross-sectional study was conducted involving 122 participants with myopia in Beijing Tongren Hospital from February to June, 2023. After completing the Ocular Surface Disease Index (OSDI) score scale, measurements were taken for refraction, biometric parameters and ocular surface parameters. The prevalence, severity and related parameters of the dry eye among different groups based on axial length (AL) were compared. Correlation analysis was performed between ocular surface parameters and refraction/biometric measurement parameters.
    RESULTS: Statistically significant differences were observed in refractive error, corneal thickness, anterior chamber depth, and subfoveal choroidal thickness among the groups (all P<0.05). With the increase in AL, the incidence and severity of dry eye increased significantly (P<0.05). Moreover, the tear film break-up time (BUT) shortened (P<0.05), and the corneal fluorescein staining (CFS) points increased significantly (P<0.05). OSDI scores were positively correlated with AL and spherical equivalent (SE; both P<0.05); BUT was negatively correlated with AL, SE, and corneal astigmatism (AST; all P<0.05); Schirmer I test (SIT) results were negatively correlated with AL and SE (both P<0.05).
    CONCLUSIONS: AL elongation is a risk factor for dry eye onset in myopic participants. The longer the AL, the more severe the dry eye is, with the increased CFS spots and tear film instability. Additionally, SE and AST exhibit negative correlations with dry eye symptom scores and ocular surface parameters.
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  • 文章类型: Journal Article
    睑板腺功能障碍(MGD)越来越被认为是蒸发性干眼的关键原因。显著影响视觉质量。全球患病率估计为35.8%,这给临床医生带来了巨大的挑战.MGD的常规手动评估技术面临效率低下的局限性,主观性高,大数据处理能力有限,缺乏定量分析工具。随着人工智能(AI)技术的迅速发展,彻底改变了眼科,研究现在正在利用复杂的人工智能方法,包括计算机视觉,无监督学习,和监督学习,促进睑板腺(MG)评估的综合分析。这些评估采用了各种技术,包括裂隙灯检查,红外成像,共聚焦显微镜,光学相干层析成像。这种范式转变有望提高疾病评估和严重程度分类的准确性和一致性。虽然人工智能在睑板腺评估方面取得了初步进展,系统开发和临床验证的持续进步势在必行。我们回顾了MG评估的演变,将人工智能驱动的方法与传统方法并列,阐明了各种人工智能技术的具体作用,并使用各种评估技术探索其实际应用。此外,我们深入研究了人工智能技术临床部署的关键考虑因素,并设想了未来的前景,为MG评估提供新的见解,并促进这一领域的技术和临床进展。
    Meibomian gland dysfunction (MGD) is increasingly recognized as a critical contributor to evaporative dry eye, significantly impacting visual quality. With a global prevalence estimated at 35.8 %, it presents substantial challenges for clinicians. Conventional manual evaluation techniques for MGD face limitations characterized by inefficiencies, high subjectivity, limited big data processing capabilities, and a dearth of quantitative analytical tools. With rapidly advancing artificial intelligence (AI) techniques revolutionizing ophthalmology, studies are now leveraging sophisticated AI methodologies--including computer vision, unsupervised learning, and supervised learning--to facilitate comprehensive analyses of meibomian gland (MG) evaluations. These evaluations employ various techniques, including slit lamp examination, infrared imaging, confocal microscopy, and optical coherence tomography. This paradigm shift promises enhanced accuracy and consistency in disease evaluation and severity classification. While AI has achieved preliminary strides in meibomian gland evaluation, ongoing advancements in system development and clinical validation are imperative. We review the evolution of MG evaluation, juxtapose AI-driven methods with traditional approaches, elucidate the specific roles of diverse AI technologies, and explore their practical applications using various evaluation techniques. Moreover, we delve into critical considerations for the clinical deployment of AI technologies and envisages future prospects, providing novel insights into MG evaluation and fostering technological and clinical progress in this arena.
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  • 文章类型: Journal Article
    干眼症是一种常见的眼科疾病。泪膜的高渗性环境中的眼部表面炎症在干眼进展中是关键的。槲皮素具有很强的抗炎作用;然而,其在干眼症中的确切作用机制尚不完全清楚。因此,这项研究调查了槲皮素是否可以通过其抗炎作用抑制高渗性环境中人角膜上皮细胞(HCECs)的损伤.HCECs在完全培养基中培养,分为四组:正常,模型,槲皮素,和抑制剂。Ki67染色检测HCECs的增殖;PTEN的表达水平,免疫印迹和免疫荧光染色检测p-PI3K和p-AKT;PTENmRNA相对表达水平,PI3K,AKT,实时定量PCR检测IL-6和TNF-α,酶联免疫吸附法检测IL-6和TNF-α的相对表达水平。在这项研究中,与正常组相比,模型组HCECs的增殖受到显著抑制;槲皮素可有效改善HCECs的增殖,降低p-PI3K的相对表达,p-AKT,IL-6、TNF-α以及增加PTEN。总之,本研究表明,槲皮素可以通过抑制高渗透压诱导的HCECs模型中的PTEN/PI3K/AKT通路,促进HCECs的增殖,减少炎症因子的表达。
    Dry eye is a prevalent ophthalmic disease. Ocular surface inflammation in the hyperosmolar environment of the tear film is critical in dry eye progression. Quercetin has strong anti-inflammatory effects; however, its exact mechanism of action in dry eye is not fully understood. Therefore, this study investigated whether quercetin could inhibit the damage sustained to human corneal epithelial cells (HCECs) in a hyperosmolar environment through its anti-inflammatory effects. HCECs were cultured in a complete medium and were divided into four groups: normal, model, quercetin, and inhibitor. The proliferation of HCECs was detected by Ki67 staining; the expression levels of PTEN, p-PI3K and p-AKT were detected by Western blotting and immunofluorescence staining; the relative mRNA expression levels of PTEN, PI3K, AKT, IL-6 and TNF-ɑ were detected by quantitative real-time PCR; the relative expression levels of IL-6 and TNF-α were detected by enzyme-linked immunosorbent assay. In this study, the proliferation of HCECs in the model group was found to be significantly inhibited compared with that in the normal group; however, quercetin was effective in improving the proliferation of HCECs, decreasing the relative expression of p-PI3K, p-AKT, IL-6, TNF-ɑ as well as increasing PTEN. In conclusion, this study demonstrated that quercetin could promote the proliferation of HCECs and reduce the expression of inflammatory factors by inhibiting the PTEN/PI3K/AKT pathway in the hyperosmolarity-induced HCECs model.
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  • 文章类型: Journal Article
    目的:本研究调查了盘状结构域受体(DDR)在干眼中的参与,并通过探索潜在的机制评估了特异性DDR抑制剂作为干眼治疗策略的潜力。
    方法:应用0.2%苯扎氯铵(BAC)诱导Wistar大鼠干眼,之后用DDR1的选择性抑制剂DDR1-IN-1局部治疗大鼠7天。在治疗后第7天评估干眼的临床表现。使用苏木精和曙红(H&E)染色进行角膜损伤的组织学评估。体外,用不同剂量的DDR1-IN-1处理暴露于高渗应激(HS)的永生化人角膜上皮细胞(HCECs)24小时。评估了干眼角膜或HS刺激的HCECs中脂质过氧化的水平。通过蛋白质印迹法检测DDRl/DDR2的蛋白水平和相关途径。使用免疫组织化学或免疫荧光染色评估酰基辅酶A合成酶长链家族成员4(ACSL4)和Yes相关蛋白(YAP)的细胞分布。
    结果:在干眼角膜中,与正常对照组相比,只有DDR1表达显着上调。DDR1-IN-1治疗可显著缓解体内干眼症状。该治疗显着降低了脂质过氧化氢(LPO)水平并抑制了铁凋亡标志物的表达,特别是ACSL4。YAP的过表达或再激活降低了DDRl-IN-1的保护作用,表明Hippo/YAP途径参与了DDRl靶向治疗作用。
    结论:该研究证实了DDR1在干眼中的重要性,并强调了选择性DDR1抑制剂用于干眼治疗的潜力。
    OBJECTIVE: This study investigated the involvement of discoidin domain receptor (DDR) in dry eye and assessed the potential of specific DDR inhibitors as a therapeutic strategy for dry eye by exploring the underlying mechanism.
    METHODS: Dry eye was induced in Wistar rats by applying 0.2% benzalkonium chloride (BAC), after which rats were treated topically for 7 days with DDR1-IN-1, a selective inhibitor of DDR1. Clinical manifestations of dry eye were assessed on Day-7 post-treatment. Histological evaluation of corneal damage was performed using haematoxylin and eosin (H&E) staining. In vitro, immortalized human corneal epithelial cells (HCECs) exposed to hyperosmotic stress (HS) were treated with varying doses of DDR1-IN-1 for 24 h. The levels of lipid peroxidation in dry eye corneas or HS-stimulated HCECs were assessed. Protein levels of DDR1/DDR2 and related pathways were detected by western blotting. The cellular distribution of acyl-CoA synthetase long chain family member 4 (ACSL4) and Yes-associated protein (YAP) was evaluated using immunohistochemistry or immunofluorescent staining.
    RESULTS: In dry eye corneas, only DDR1 expression was significantly up-regulated compared with normal controls. DDR1-IN-1 treatment significantly alleviated dry eye symptoms in vivo. The treatment remarkably reduced lipid hydroperoxide (LPO) levels and suppressed the expression of ferroptosis markers, particularly ACSL4. Overexpression or reactivation of YAP diminished the protective effects of DDR1-IN-1, indicating the involvement of the Hippo/YAP pathway in DDR1-targeted therapeutic effects.
    CONCLUSIONS: This study confirms the significance of DDR1 in dry eye and highlights the potential of selective DDR1 inhibitor(s) for dry eye treatment.
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  • 文章类型: Journal Article
    目的:探讨原发性获得性鼻泪管阻塞(PANDO)患者干眼(DE)的患病率和泪膜稳定性的变化。
    方法:在此横截面中,观察性研究,对223例PANDO患者的370只眼进行了评估。眼表疾病指数(OSDI)用于评估眼表症状,并使用角膜摄影5M无创眼表分析仪评估眼表参数。根据TFOSDEWSII标准,OSDI≥13且NIKBUT<10s的患者被诊断为DE。
    结果:在223名PANDO患者中,65(29.1%)符合DE的诊断标准。与没有DE的患者相比,患有DE的PANDO患者明显年龄较大(p<0.001),有一个较长的持续时间的溢泪(p=0.023),并且更可能对泪囊压力(ROPLAS)信号(p=0.003)有正反流。多因素分析表明,年龄较大,ROPLAS阳性和高血压是DE的显著独立预测因子(p<0.05)。在147例无DE的单侧PANDO患者中,TMH,NIKBUT-First,PANDO两侧的NIKBUT平均和球红斑评分明显较高。
    结论:这项研究表明,在PANDO患者中,DE的患病率为29.1%,并且在年龄较大的患者中更容易发生,有高血压,ROPLAS阳性。此外,单侧鼻泪管阻塞的患者,在健康眼睛中观察到泪膜稳定性降低。
    OBJECTIVE: Exploring the prevalence of dry eye (DE) and the changes of tear film stability in patients with primary acquired obstruction of the nasolacrimal duct (PANDO).
    METHODS: In this cross-sectional, observational study, 370 eyes in 223 patients with PANDO were assessed. The ocular surface disease index (OSDI) was used to evaluate ocular surface symptoms, and the Keratograph 5M non-invasive ocular surface analyser was used to assess ocular surface parameters. According to the TFOS DEWS II criteria, patients with OSDI ≥ 13 and NIKBUT < 10 s were diagnosed with DE.
    RESULTS: Of the 223 PANDO patients, 65 (29.1%) met the diagnostic criteria for DE. Compared with patients without DE, PANDO patients with DE were significantly older (p < 0.001), had a longer duration of epiphora (p = 0.023), and more likely to have a positive regurgitation on pressure over the lacrimal sac (ROPLAS) sign (p = 0.003). Multifactorial analysis showed that older age, positive ROPLAS and hypertension were significant independent predictors of DE (p < 0.05). Among the 147 unilateral PANDO patients without DE, the TMH, NIKBUT-first, NIKBUT-average and bulbar erythema scores were significantly higher in the PANDO sides.
    CONCLUSIONS: This study illustrated the prevalence of DE in PANDO patients was 29.1% and DE is more likely to occur in those who are older, have hypertension and are positive for ROPLAS. In addition, in patients with unilateral nasolacrimal duct obstruction, a decrease in tear film stability was observed in the healthy eye.
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  • 文章类型: Journal Article
    目的:I-131治疗后与分化型甲状腺癌(DTC)相关的最常见的泪器功能障碍是干眼和鼻泪管阻塞(NLDO),导致患者眼部不适和生活质量下降。诊断和管理与I-131治疗DTC相关的泪器功能障碍至关重要。因此,本文旨在全面总结和分析I-131治疗DTC导致泪器功能障碍的机制和治疗方案的进展。
    方法:CNKI综合检索,PubMed,和WedofScience从数据库中进行到2023年12月。关键搜索词是\"甲状腺癌\",\"I-131\",“并发症”,\"干眼\",\"Epiphora\",\"眼泪\",“鼻泪管”和“NLDO”。
    结果:研究表明,I-131治疗DTC会对泪腺和鼻泪管系统造成损害,导致干眼症等症状,顿唇,还有粘液分泌物.此外,最近的研究集中在探索疾病的相关危险因素以及实验和临床治疗。然而,关于所涉及的机制存在一些争议,无论是由于I-131在眼泪中的被动流动,泪囊和鼻泪管中的钠碘转运体(NIS)主动摄取I-131,或由I-131引起的继发性代谢和激素紊乱。
    结论:眼科医生的早期发现和预防措施至关重要,并且需要进一步研究以阐明该疾病的潜在机制。
    OBJECTIVE: The most prevalent lacrimal apparatus dysfunctions associated with differentiated thyroid cancer(DTC) after I-131 therapy are dry eye and nasolacrimal duct obstruction(NLDO), leading to ocular discomfort and lower quality of life for patients. It is crucial to diagnose and manage lacrimal apparatus dysfunction associated with I-131 therapy for DTC. Therefore, this review aims to comprehensively summarize and analyze the advances in mechanisms and therapeutic options underlying lacrimal apparatus dysfunction induced by I-131 therapy for DTC.
    METHODS: A comprehensive search of CNKI, PubMed, and Wed of Science was performed from the database to December of 2023. Key search terms were \"Thyroid cancer\", \"I-131\", \"Complications\", \"Dry eye\", \"Epiphora\", \"Tear\", \"Nasolacrimal duct\" and \"NLDO\".
    RESULTS: The research indicates that I-131 therapy for DTC causes damage to the lacrimal glands and nasolacrimal duct system, resulting in symptoms such as dry eye, epiphora, and mucoid secretions. Moreover, recent research has focused on exploring relevant risk factors of the condition and experimental and clinical treatments. However, there is some controversy regarding the mechanisms involved, whether it is due to the passive flow of I-131 in tears, active uptake of I-131 by the sodium-iodide symporter (NIS) in the lacrimal sac and nasolacrimal duct, or secondary metabolic and hormonal disturbances caused by I-131.
    CONCLUSIONS: It is crucial for early detection and preventive measures by ophthalmologists and the need for further studies to elucidate the mechanisms underlying the disease.
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  • 文章类型: Journal Article
    背景:干眼症是一种由泪膜不稳定或眼表微环境失衡引起的慢性多因素眼表疾病。它可能导致各种不适,例如眼表炎症和视觉问题。然而,干眼症的发病机制尚不清楚,这导致干眼症在临床实践中只能缓解但不能治愈。寻找干眼症的多种环境通路,探索干眼症的发病机制已成为研究的热点。研究发现,微生物群的变化可能与干眼病的发生、发展有关。
    方法:输入关键字\"干眼\",\"微生物群\",“细菌”通过pubmed,总结了符合纳入标准的文章,然后在过去5年中定义了文献的发表时间范围的同时对其进行过滤,截止日期为2023年。共筛选出13篇临床和1篇动物相关研究文章,纳入总结。
    结果:研究发现,细菌的不同成分可以通过存在于眼表的不同受体诱导眼部免疫反应,从而导致眼表微环境的不平衡。当干眼综合征发生时,还发现眼表微生物群和肠道微生物群的变化,包括多样性的变化,促炎细菌的增加,以及产生抗炎作用的短链脂肪酸相关细菌属的减少。粪便微生物移植或益生菌干预可减轻干眼动物模型眼表的炎症体征。
    结论:通过总结干眼发生时眼表和肠道菌群的变化,推测并得出结论,肠道可能通过多种途径和机制影响干眼症等眼部疾病的发生,例如异常免疫反应的发生,微生物群代谢-短链脂肪酸的干预,促炎和抗炎因子失衡,和神经递质的释放,等。从微生物群角度分析肠道与眼睛的相关性,可为今后多方位缓解干眼症提供理论依据和新思路。
    BACKGROUND: Dry eye is a chronic and multifactorial ocular surface disease caused by tear film instability or imbalance in the microenvironment of the ocular surface. It can lead to various discomforts such as inflammation of the ocular surface and visual issues. However, the mechanism of dry eye is not clear, which results in dry eye being only relieved but not cured in clinical practice. Finding multiple environmental pathways for dry eye and exploring the pathogenesis of dry eye have become the focus of research. Studies have found that changes in microbiota may be related to the occurrence and development of dry eye disease.
    METHODS: Entered the keywords \"Dry eye\", \"Microbiota\", \"Bacteria\" through PUBMED, summarised the articles that meet the inclusion criteria and then filtered them while the publication time range of the literature was defined in the past 5 years, with a deadline of 2023.A total of 13 clinical and 1 animal-related research articles were screened out and included in the summary.
    RESULTS: Study found that different components of bacteria can induce ocular immune responses through different receptors present on the ocular surface, thereby leading to an imbalance in the ocular surface microenvironment. Changes in the ocular surface microbiota and gut microbiota were also found when dry eye syndrome occurs, including changes in diversity, an increase in pro-inflammatory bacteria, and a decrease in short-chain fatty acid-related bacterial genera that produce anti-inflammatory effects. Fecal microbiota transplantation or probiotic intervention can alleviate signs of inflammation on the ocular surface of dry eye animal models.
    CONCLUSIONS: By summarizing the changes in the ocular surface and intestinal microbiota when dry eye occurs, it is speculated and concluded that the intestine may affect the occurrence of eye diseases such as dry eye through several pathways and mechanisms, such as the occurrence of abnormal immune responses, microbiota metabolites- intervention of short-chain fatty acids, imbalance of pro-inflammatory and anti-inflammatory factors, and release of neurotransmitters, etc. Analyzing the correlation between the intestinal tract and the eyes from the perspective of microbiota can provide a theoretical basis and a new idea for relieving dry eyes in multiple ways in the future.
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