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TFOS DEWS二期诊断方法报告 TFOS DEWS II Diagnostic Methodology report

Wolffsohn JS, Arita R, Chalmers R, Djalilian A, Dogru M, Dumbleton K, Gupta PK, Karpecki P, Lazreg S, Pult H, Sullivan BD, Tomlinson A, Tong L, Villani E, Yoon KC, Jones L, Craig JP

期刊名称:The Ocular Surface

卷期:2017年第15卷第3期

关键词:
诊断方法 报告

摘要

摘要:泪膜及眼表协会干眼工作小组Ⅱ诊断方法小组委员会成员制定用来诊断和管理干眼症的试验,为干眼症及其亚型阐述合适的定义,在某一临床设定中采取合适的顺序及技术来执行这些试验,并且提供干眼症的差异性诊断以及区分可能合并干眼症的环境。在诊断之前,重要的是排除由于鉴别诊断问题带来的与干眼症相似的病例。通过DEQ-5OSDI的症状筛选表明患者很可能已经患有干眼症并触发诊断试验(通常是非侵入性的)的泪膜破裂时间,摩尔渗透压浓度以及使用荧光素和丽丝胺绿染色(观察角膜、结膜和眼睑边缘)。睑板腺功能异常,液体缺乏/动力学,泪液容量评估,以及病情严重性决定了干眼症的亚分型(主要为蒸发行和泪液缺乏型),这些也是干眼症管理的决定因素。这些诊断和分类技术的视频可以在TFOS网站上搜索到。设想一下对干眼症及其亚分类诊断和监管的关键测试进行分类,将会对未来的流行病学研究和管理临床试验起到重要作用,这将会提高可比性,并有利于确定干眼症亚型的分类方法,使不同病症的管理策略更加有效。

 

The role of the Tear Film and Ocular Surface Society (TFOS) Dry Eye Workshop (DEWS) II Diagnostic Methodology Subcommittee was 1) to identify tests used to diagnose and monitor dry eye disease (DED), 2) to identify those most appropriate to fulfil the definition of DED and its sub-classifications, 3) to propose the most appropriate order and technique to conduct these tests in a clinical setting, and 4) to provide a differential diagnosis for DED and distinguish conditions where DED is a comorbidity. Prior to diagnosis, it is important to exclude conditions that can mimic DED with the aid of triaging questions. Symptom screening with the DEQ-5 or OSDI confirms that a patient might have DED and triggers the conduct of diagnostic tests of (ideally non-invasive) breakup time, osmolarity and ocular surface staining with fluorescein and lissamine green (observing the cornea, conjunctiva and eyelid margin). Meibomian gland dysfunction, lipid thickness/dynamics and tear volume assessment and their severity allow sub-classification of DED (as predominantly evaporative or aqueous deficient) which informs the management of DED. Videos of these diagnostic and sub-classification techniques are available on the TFOS website. It is envisaged that the identification of the key tests to diagnose and monitor DED and its sub-classifications will inform future epidemiological studies and management clinical trials, improving comparability, and enabling identification of the sub-classification of DED in which different management strategies are most efficacious.


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