Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2019, Vol. 33 ›› Issue (2): 159-166.doi: 10.6040/j.issn.1673-3770.0.2018.411

Previous Articles    

SUN Ziwen1, CUI Hongwei2, SUN XilingEtiology, pathogenesis, and management of dry eye

SUN Ziwen1, CUI Hongwei2, SUN Xiling3, CHEN Chen1, ZHANG Lu1, HU Zhulin1   

  1. Department of Neurosurgery, Clinical Medicine College, Weifang Medical University, Weifang 261036, Shandong, China;
    3. Traditional Chinese Medicine, Binzhou Medical University, Integrated Chinese and Western Medicine College, Yantai 264000, Shandong, China
  • Published:2019-03-28

Abstract: Due to multiple influences of internal factors(tear film destruction, sex hormone disorders)and external factors(environment, surgery, and drugs), patients with dry eye disease have been encountered much more frequently and are presenting at a younger age. Dry eye disease has become one of the most common diseases of the ocular surface, with a multifactorial etiology. This paper reviews the newer reports on etiology, pathogenesis, and management of dry eye.

Key words: Dry eye, Etiology, Pathogenesis, Management breakthrough

CLC Number: 

  • R77
[1] Juanjuan Li, Yunpeng Li, Meixia Zhang, et al. Silencing of Rac1 expression via RNA interference inhibits retinal neovascularization in rats[J]. Molecular Vision, 2012, 18:1354-1360. Epub 2012 May 30.
[2] Craig JP, Nelson JD, Azar DT, et al. The TFOS Dry Eye Workshop II: Executive Summary[J]. Ocul Surf, 2017.
[3] Messmer EM. Novel current and future therapy options for treatment of dry eye disease[J]. Ophthalmologe, 2018, 115(2):100-106.
[4] Garg A, Zhang X. Lacrimal gland development: from signaling interactions to regenerative medicine[J]. Dev Dyn, 2017, 246(12):970-980.
[5] 周杨, 王传富, 姜涛. 摘除主泪腺干眼病鼠泪液功能变化与凋亡相关基因蛋白的表达[J]. 中华眼科杂志, 2007, 43(1):18-22. ZHOU Yang, WANG Chuanfu, JIANG Tao. Expression of apoptosis related genes and changes of lacrimal functions in main lacrimal gland extirpation xerophthalmia model[J]. Chin J Ophthalmology, 2007, 43(1):18-22.
[6] Garg A, Zhang X. Lacrimal gland development: from signaling interactions to regenerative medicine[J]. Dev Dyn,2017, 246(12):970-980.
[7] 田玉景, 刘焰, 邹海东, 等. 上海市江宁街道20岁及以上人群干眼的流行病学调查[J]. 中华眼科杂志, 2009, 45(6):486-491. TIAN Yujing, LIU Yan, ZOU Haidong, et al. Epidemiologic study of dry eye in populations equal or over 20 years old in Jiangning District of Shanghai[J]. Chin J Ophthalmology, 2009, 45(6):486-491.
[8] Shine WE, McCulley JP. KeratoconiunctiviIis sieca associated with meibomiansecretion polar lipid abnormality[J]. Arch Ophthalmol, 1998, 116(7):849-852.
[9] Argueso P, Gipson IK. Assessing mucin expression and function in human ocular surface epithelia in vivo and in vitro[J]. Methods Mol Biol, 2012, 842:313-325. doi: 10.1007/978-1-61779-513-8_19.
[10] 祁俏然, 沈光林, 马晓萍. 眼表黏蛋白的研究进展及其与干眼的相关性[J].国际眼科杂志,2016,16(4):681-685. QI QiaoRan, SHEN Guanglin, MA Xiaoping. Research progress on mucin and its relevance to dry eye[J]. Int Eye Sci, 2016, 16(4):681-685.
[11] Gipson IK, Spurr-Michaud SJ, Senchyna M, et al. Comparison of mucin levels at the ocular surface of postmenopausal women with and without a history of dry eye[J]. Cornea, 2011, 30(12):1346-1352.
[12] Forsblad-dElia H, Carlsten H, Labile F, et al. Low serum levels of sex steroids are associated with disease characteristics in primary Sjogrens syndrome,supplementation with dehydroepiandrosterone restores the concentrations[J]. J Clin Endocrinol Metab, 2009, 94(6):2044-2051.
[13] 袁进, 邓宇晴. 重视糖尿病相关干眼的诊断与治疗[J]. 中华眼科杂志, 2017, 53(9):645-647. YUAN Jin, DENG Yuqing. Emphasizing the diagnosis and treatment of diabetes related dry eye[J]. Chin J Ophthalmology, 2017, 53(9):645-647.
[14] 左兆羊, 沈光林, 祁俏然, 等. 干眼与睡眠障碍相关性研究进展[J]. 中国实用眼科杂志, 2016, 34(6):521-525.
[15] 柯宁, 赵敏. 干眼的免疫学研究现状及进展[J]. 中国实用眼科杂志, 2006, 24(10):1009-1013.
[16] Toshida H, Nguyen DH, Beuerman RW, et al. Evaluation of novel dry eye model:preganglionic parasympathetic denervation in rabbit[J]. Invest Ophthalmol Vis Sci, 2007, 48(10):4468-4475.
[17] Linna TU, Vesaluoma MH, Perez-Santonja JJ, et al. Effect of myopic LASIK on corneal sensitivity and morphology of subbasal nerves[J]. Invest Ophthalmol Vis Sci, 2000, 41(2):393-397.
[18] Albietz JM, Lenton LM, McLennan SG. Effect of Laser in situ keratomileusis for hypopia on tear film and ocular surface[J]. J Refract Surg, 2002, 18(2):113-123.
[19] Stepp MA, Pal-Ghosh S, Tadvalkar G, et al. Reduced intraepithelial corneal nerve density and sensitivity accompany desiccating stress and aging in C57BL/6 mice[J]. Exp Eye Res, 2018, 169:91-98. doi: 10.1016/j.exer.2018.01.024. Epub 2018 Jan 31.
[20] 张传伟, 李凯, 王育良. 干眼患者主观症状及客观体征的相关性研究[J]. 国际眼科杂志, 2011, 11(7):1250-1251. ZHANG Chuanwei,LI Kai,WANG Yuliang. Study on the correlation between symptom and sign of patients with dry eye[J]. Int J Ophthamol, 2011, 11(7):1250-1251.
[21] 刘景祥, 李燕伟, 张冰洁. 干眼症患者泪液乳铁蛋白检测的意义[J]. 中国实验诊断学, 2006, 10(6):663-665. LIU Jingxiang, LI Yanwei, ZHANG Bingjie. The detect signification of lactoferrin in tears of patients with dry eye[J]. Chin J Lab Diagn, 2006, 10(6):663-665.
[22] Tavakoli M, Kallinikos PA, Efron N, et al. Corneal sensitivity is reduced and relates to the severity of neuropathy in patients with diabetes[J]. Diabetes Care, 2007, 30(7):1895-1897.
[23] 胡春玲, 吴丽萍, 张悦, 等. 上海市社区中老年干眼患者局部特征与影响因素分析[J]. 国际眼科杂志, 2016, 16(9):1715-1719. HU Chunling, WU Liping, ZHANG Yue, et al. Investigation of ocular characteristics and effect in middle aged and elderly people with dry eye disease in the community of Shanghai[J]. Int Eye Sci, 2016, 16(9):1715-1719.
[24] 张菊,吴欣怡. 手术相关的干眼研究进展[J]. 中国实用眼科杂志, 2014, 32(10):1144-1146.
[25] 陈家祺, 袁进. 重视手术源性干眼及其治疗[J]. 眼科, 2008, 17(3):151-153. CHEN Jiaqi, YUAN Jin. Attach more importances to dry eye correlated with operation[J]. Ophthalmol CHN, 2008, 17(3):151-153.
[26] Pflugfelder SC, Solomon A, Stern ME. The diagnosis and management of dry eye:a twenty-five-year rgview[J]. Cornea, 2000, 19(5):644-649.
[27] 杨万举, 杨燕宁, 邢怡桥, 等. 干眼病危险因素的病例对照研究[J]. 中华临床医师杂志(电子版), 2012, 6(15):4315-4321. YANG Wanju, YANG Yanning, XING Yiqiao, et al. The risk factors of dry eye in wuhan: a case-control analysis[J]. Chin J Clinicians(Electronic Edition), 2012, 6(15):4315-4321.
[28] 李红月, 孙艳, 刘长宏, 等. 不同人群干眼病形成病因分析[J]. 医学美学美容(中旬刊), 2015, 4:2.
[29] 左春兰. 干眼症的相关因素分析[J]. 中国实用眼科杂志, 2015, 33(z1):1-3.
[30] The definition and classification of Dry Eye Disease:Report of the Definition and classification subcommittee of the international Dry Eye Work shop(2007)[J]. Ocul surf, 2007, 5(2):75-92.
[31] Chen GY, Nufiez G. Sterile inflammation:sensing and reacting to damage[J]. Nat Rev Immunol, 2010, 10(12):826-837.
[32] Li DQ, Chen Z, Song XJ, et al. Stimulation of matrix metallo-proteinases by hyperosmolarity Via a JNK pathway in human corneal epithelial cells[J]. Invest 0phthalmol Vis sci, 2004, 45(12):4302-4311.
[33] 褚晨晨, 茹玉莎, 张琰, 等. 干眼新型干预手段的研究进展及其对眼表微环境的保护作用机制[J]. 国际眼科纵览, 2017, 41(6):400-405. CHU Chenchen, RU Yusha, ZHANG Yan, et al. Research progress on new intervention methods for dry eye and their mechanisms of protective effects on ocular surface microenvironment[J]. Int Rev Ophthalmol, 2017, 41(6):400-405.
[34] Yeh S, Song XJ, Farley W, et al. Apoptosis of ocular surface cells in experimentally induced dry eye[J]. Invest 0phthalmol Vis Sci, 2003, 44(1):124-129.
[35] 丛晨阳, 毕宏生, 温莹. 干眼症发病机制和治疗方法的研究进展[J]. 国际眼科杂志, 2012, 12(3):464-467. CONG Chenyang, BI Hongsheng, WEN Ying. Research advance of the pathogenesis and treatment of dry eye[J]. Int Eye Sci, 2012, 12(3):464-467.
[36] Blalock TD, Spurr-Michaud SJ, Tisdale AS, et al. Release of membrane-associated mucins from ocular surface epithelia[J]. Invest Ophthalmol Vis Sci, 2008, 49:1864-1871.
[37] Moss SE, Klein R, Klein BE. Incidence of dry eye in an older population[J]. Arch Ophthalmol, 2004, 122(3):369-373.
[38] 林通, 龚岚. 性激素与干眼的相关性研究进展[J]. 中华眼科杂志, 2014, 50(1):65-68. LIN Tong, GONG Lan. Progression of research for the association between sex hormones and dry eye[J]. Chin J Ophthalmol, 2014, 50(1):65-68.
[39] Sullivan DA, Wickham LA, Rocha EM, et al. Androgens and dry eye in Sjögrens syndrome[J].Ann N Y Acad Sci, 1999, 22, 876:312-324.
[40] 秦毅, 潘志强. 干眼的病因、发病机制与治疗进展[J]. 中华眼科杂志, 2013, 49(9):857-863. QIN Yi,PAN Zhiqiang. Recent advances in dry eye:etiology,pathogenesis and management[J]. Chin J Ophthalmol, 2013, 49(9):857-863.
[41] Knop N, Knop E. Regulation of the inflammatory component in chronic dry eye disease by the eye—associated lymphoid tissue(EALT)[J]. Dev Ophthalmol, 2010, 45:23-39. doi: 10.1159/000315017. Epub 2010 May 18.
[42] Seamon V, Vellala K, Zylberberg C, et al. Sex hormone regulation of tear lipocalin in the rabbit lacrimal gland[J]. Exp Eye Res, 2008, 87(3):184-190.
[43] Srikantan S, Paliwal A, Quintanar-Stephano A, et al. Estrogen and androgenrepression of two female specific lacrimal lipocalins in hamster:Pituitary independent and sex hormone receptor mediated action[J]. Gen Comp Endocrinol, 2007, 151(2):172-179.
[44] 刘祖国. 干眼的诊断[J]. 中华眼科杂志, 2002, 38(5):318-320.
[45] Tuominen ISJ, Konttinen YT, Vesaluoma MH, et al. Corneal innervation and morphology in primary Sjogrens syndrome[J]. Invest Ophtahlmol Vis Sci, 2003, 44(6):2545-2549.
[46] 张丹, 赵嬿, 魏邦基, 等. 神经损伤和神经生长因子与干眼发病机制的研究进展[J]. 中国中医眼科杂志, 2015, 25(5):381-384. ZHANG Dan, ZHAO Yan, WEI Bangji, et al. Research progress of role of neural damage and nerve growth factor in pathogenesis of dry eye[J]. Chinese Journal of Chinese Ophthalmology, 2015, 25(5):381-384.
[47] Mantelli F, Argueso P. Functions of ocular surface mucins in health and disease[J]. Curr Opin Allergy Clin Immunol, 2008, 8(5):477-483
[48] Bharathi G, Gipson IK. Membrane-tethered mucins have multiple functions on the ocular surface[J]. Exp Eye Res, 2010, 90(6):655-663.
[49] Tei M, Spurr-Michaud S, Tisdale AS, et al. Vitamin A deficiency alters the expression of mucin genes by the rat ocular surface epithelium[J]. Invest Ophthalmol Vis Sci, 2000, 41(1):82-88.
[50] Zamzami N, Marchetti P, Castedo M, et al. Sequcntial reduction of mitochondrial transmembrane potential and generation of reactive oxygen species in early programmed cell death[J]. J Exp Med, 1995, 182(2):1367-1377.
[51] Krab DR, Greiner JV. Increase in lear flim lipid layer thickness following treatment of meibomian gland dysfunction[J]. Adv Exp Med Biol, 1994, 350:293-298.
[52] 武建华. 干眼症的病因及诊治[J]. 中国医药指南, 2013, 19:476-477.
[53] Sheppard JD, Scoper SV, Samudre S. Topical loteprednol pretreatment reduces cyclosporine stinging in chronic dry eye disease[J]. J 0cuI Pharmacol Ther, 2011, 27(1):23-27.
[54] Gibbons CH, Freeman R. Antibody titers predict clinical features of autoimmune autonomic gang1ionopathy[J]. Auton Neuro Sci, 2009, 146(1-2):8-12.
[55] Shafaa MW, El shazly LH, El Shazly AH, et al. Efficacy of topically appIied liposome-bound tetracycline in the treatment of dry eye model[J]. Vet 0phthalmol, 2011, 14(1):18-25.
[56] Rosenberg ES, Asbell PA. Essential fatty acids in the treatment of dry eye[J]. 0cul Surf, 20l0, 8(1):18-28.
[57] Ozcura F, Dundar SO, Cetin ED, et al. Effects of estrogen replacement therapy on apoptosis and vascular endothelial growth factor expression in ocular surface epithelial cells:an experimental study[J]. Int J Ophthalmol, 2012, 5(1):64-68.
[58] 高卫萍,李影. 眼周针刺对干眼患者泪液流量及泪膜的影响[J]. 辽宁中医药大学学报, 2011, 13(7):22-24. GAO Weiping, LI Ying. Effect of Acupuncture Points Around Eyes on the Quantity of Tears and Tear Film in Dry Eye Patients[J]. J Liaoning Univ TCM, 2011, 13(7):22-24.
[59] 冯清云, 满在山, 李荟. 电针治疗干眼症32例[J]. 山东中医杂志, 2013, 32(3):182-183.
[60] 王锋. 电脑多功能治疗仪治疗睑板腺功能障碍性干眼症的临床观察[J]. 社区医学杂志, 2012, 10(10):38-39.
[61] Chang YH, Lin HJ, Li WC. Clinical evalution of the traditional Chinese prescription Chi-Ju-Di-Huang-Wan for dry eye[J]. Phytother Res, 2005, 19(4):349-354.
[62] 陈建峰, 冯艳敏, 陈娇英. 八物汤治疗干眼症的临床观察[J]. 中国中医眼科杂志, 2007, 17(3):163.
[63] 赵学章. 中西医结合治疗干眼症的疗效观察[J]. 亚太传统医药, 2009, 5(1):63-64.
[64] 龙达, 唐罗生. 青少年缺血性眼病研究进展[J]. 眼科研究, 2010, 28(12):1196-1200. LONG Da, TANG Luosheng. Current advance in juvenile ischemic ophthalmopathy[J]. Chin Ophthalmic Res, 2010, 28(12):1196-1200.
[65] 魏世辉. 颈动脉狭窄引起的眼部缺血性病变[J]. 中华眼底病杂志, 2007, 23(3):222-224.
[66] 胡昊, 俞进展. 脑梗死后眼干症状的分析及对策[J]. 基层医学论坛, 2012, 34:4555-4556.
[1] WANG Yue, LIU Qian, WANG Haibo. Prospect and progress of spontaneous cerebrospinal fluid otorrhea [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(2): 130-135.
[2] Chuangli HAO,Wenjing GU. Recognizing the etiology of chronic cough in children of different ages [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1): 20-24.
[3] Yu ZHANG,Xicheng SONG. Advances in interaction mechanisms and treatment strategy between chronic rhinosinusitis with nasal polyp and asthma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1): 49-52.
[4] TU Xuefeng. Clinical effect of combination therapy of sodium hyaluronate and recombinant bovine basic fibroblast growth factor on dry eye after phacoemulsification [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(6): 84-87.
[5] YANG Xue, LI Ying. Impact of dry eye on corneal endothelial cell density and morphology [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 72-76.
[6] YAN Huiqin, WANG Hao. Clinical analysis of intractable benign paroxysmal positional vertigo [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(3): 86-88.
[7] HU Jindong, LIU Xinquan. Research progress of dry eye animal model. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(4): 109-113.
[8] . Causes of non-traumatic vitreous hemorrhage and effects of surgical treatment. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(1): 107-109.
[9] WANG Yan. Progress in the classification and treatment of sleep respiratory diseases in children. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(5): 5-8.
[10] LIU Dingrong, SHI Yuyong, ZHAN Xianjin, LIU Guiling, LIAO Xinchun,YANG Ji, LUO Zehui, LUO Yonghua, LIAO Kuan, WU Ke. Computed tomographic analysis of the relationship between nasal structure and fungal maxillary inflammation. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(5): 94-97.
[11] ZHANG Ruxin. Prospect and progress of allergic rhinitis. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(4): 3-6.
[12] LIU Zhe, TENG Bo, WEN Lianji. The impact of indoor air pollutants and diet to allergic diseases. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(3): 96-102.
[13] HE Guijun, QIAN Xiaoyun, GU Yajun, LIN Chuanyao, SONG Panpan, GAO Xia. Analysis of the risk factors of proliferative laryngopharyngeal disease. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(3): 32-36.
[14] JIANG Yang, LI Ying, WANG Zhonghai, JIN Yumei, LIU Xiaowei. Effect of the implantation of lacrimal plug for dry eyes after laser assisted in-situ keratomiLeusis. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(2): 80-83.
[15] WANG Luping, WU Xinyi. Effect of glycosylated hemoglobin on dry eye in patients with type 2 diabetes mellitus [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(6): 71-73.
Full text



No Suggested Reading articles found!