糖尿病(DM)是一种慢性代谢性疾病,其特征是由于胰岛素分泌缺陷导致的高血糖,行动,或者两者兼而有之,近几十年来,全球患病率增加了两倍。这种情况带来了重大的公共卫生挑战,影响个人,医疗保健系统,和全球经济。在其众多并发症中,眼表疾病(OSD)是一个重要的问题,然而了解它的病理生理学,诊断,管理仍然具有挑战性。这篇综述旨在探讨流行病学,病理生理学,临床表现,诊断方法,糖尿病相关OSD的管理策略。眼表,包括角膜,结膜,和相关的结构,对保持眼睛健康至关重要,泪道功能单元(LFU)在泪膜调节中起着至关重要的作用。在DM中,糖胺聚糖代谢的变化,胶原蛋白合成,耗氧量,LFU功能障碍导致眼部并发症。持续的高血糖导致细胞因子的表达,趋化因子,和细胞粘附分子,导致神经病,泪膜异常,和上皮病变。分子研究和治疗方式的最新进展,比如基因和干细胞疗法,显示出管理糖尿病眼部并发症的希望。未来的研究应集中在糖尿病神经病变和角膜病变的病因导向治疗上。从动物模型过渡到临床试验,以改善患者的预后。
Diabetes mellitus (DM) is a chronic metabolic disorder marked by hyperglycemia due to defects in insulin secretion, action, or both, with a global prevalence that has tripled in recent decades. This condition poses significant public health challenges, affecting individuals, healthcare systems, and economies worldwide. Among its numerous complications, ocular surface disease (OSD) is a significant concern, yet understanding its pathophysiology, diagnosis, and management remains challenging. This review aims to explore the epidemiology, pathophysiology, clinical manifestations, diagnostic approaches, and management strategies of diabetes-related OSD. The ocular surface, including the cornea, conjunctiva, and associated structures, is vital for maintaining eye health, with the lacrimal functional unit (LFU) playing a crucial role in tear film regulation. In DM, changes in glycosaminoglycan metabolism, collagen synthesis, oxygen consumption, and LFU dysfunction contribute to ocular complications. Persistent hyperglycemia leads to the expression of cytokines, chemokines, and cell adhesion molecules, resulting in neuropathy, tear film abnormalities, and epithelial lesions. Recent advances in molecular research and therapeutic modalities, such as gene and stem cell therapies, show promise for managing diabetic ocular complications. Future research should focus on pathogenetically oriented therapies for diabetic neuropathy and keratopathy, transitioning from animal models to clinical trials to improve patient outcomes.