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Sjogren疾病相关干眼症临床治疗指南

Foulks GN, Forstot SL, Donshik PC, et al.

期刊名称:OCUL SURF 眼球表面

卷期:第13卷(2015年)2期

摘要

 本文旨在通过评价发表的治疗方案和推荐管理方案,为与Sjogren病相关的干眼病的治疗和管理提供一个统一的临床指南。为所报道的干眼病治疗方案设计统一评估模板。研究方法如下:以2007年报道的干眼症国际研讨会(DEWS)为研究起点,一组眼保健提供者和顾问对同行评审的出版物进行评估并提出用以评价和管理与Sjogren病相关的干眼病建议。出版物按照美国眼科学会首选的实践模式指南进行证据等级的分级。推荐强度是按照发展和评价(GRADE)指南建议的评估方法进行分级。研究结果如下:本文简单总结了所推荐的模板。评估过程应包括不适感和视觉障碍症状,以及水产生不足和泪液量蒸发损失相对影响的确定。应当采用泪膜稳定性,泪液渗透压,睑缘疾病的严重程度,及眼表损害程度这些客观参数来评价干眼病的阶段严重程度,以帮助患者选择合适的治疗方案。至于问题本质,加重因素以及治疗目标,病人教育程度可能是成功管理的关键因素。根据干眼症的性质和严重程度,选择采用泪液补充和稳定方法,控制泪腺和眼表面炎症方法,以及泪液产生的可能刺激的治疗方案。总结:本文介绍了与Sjogren病相关的干眼病的管理指南。

PURPOSE: To provide a consensus clinical guideline for management of dry eye disease associated with Sjogren disease by evaluating published treatments and recommending management options. DESIGN: Consensus panel evaluation of reported treatments for dry eye disease. METHODS: Using the 2007 Report of the International Workshop on Dry Eye (DEWS) as a starting point, a panel of eye care providers and consultants evaluated peer-reviewed publications and developed recommendations for evaluation and management of dry eye disease associated with Sjogren disease. Publications were graded according to the American Academy of Ophthalmology Preferred Practice Pattern guidelines for level of evidence. Strength of recommendation was according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. RESULTS: The recommendations of the panel are briefly summarized herein. Evaluation should include symptoms of both discomfort and visual disturbance as well as determination of the relative contribution of aqueous production deficiency and evaporative loss of tear volume. Objective parameters of tear film stability, tear osmolarity, degree of lid margin disease, and ocular surface damage should be used to stage severity of dry eye disease to assist in selecting appropriate treatment options. Patient education with regard to the nature of the problem, aggravating factors, and goals of treatment is critical to successful management. Tear supplementation and stabilization, control of inflammation of the lacrimal glands and ocular surface, and possible stimulation of tear production are treatment options that are used according to the character and severity of dry eye disease. SUMMARY: Management guidelines for dry eye associated with Sjogren’s disease are presented.

 

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