Dysfunctional tear syndrome - A Delphi approach to treatment recommendations
Dysfunctional tear syndrome - A Delphi approach to treatment recommendations
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DOI：
10.1097/01.ico.0000214802.40313.fa
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发表时间：
2006-09-01
期刊：
影响因子：
2.8
通讯作者：
Yiu, Samuel C.
中科院分区：
文献类型：
--
作者：
Behrens, Ashley;Doyle, John J.;Yiu, Samuel C.
目的：为了发展目前的治疗建议，从专家consensus of expert advice.Methods：25预选国际专家干眼，17同意参加一个修改后，2轮德尔菲小组的方法。根据现有文献和护理标准，向每位患者提供调查。三分之二多数用于从所获得的答复中建立共识。创建了治疗算法。不同类型和严重程度的干眼症的治疗建议是主要outcome.Results：一个新的术语干眼病的建议：功能障碍性泪液综合征（dysfunctional tear syndrome，简称dysfunctional tear syndrome，简称dysfunctional tear syndrome）。治疗建议主要基于患者的症状和体征。现有的诊断测试被认为是次要的指导治疗。算法的开发基于眼睑边缘疾病的存在或不存在以及泪液分布和清除的干扰。疾病严重程度被认为是治疗决策的最重要因素，并分为4个级别。根据泪液替代品的需求、眼部不适症状和视力障碍评估严重程度。眼睑、泪膜、结膜和角膜中存在的临床体征也用于严重程度分类。达成共识的治疗算法，并没有并发眼睑diseases.Conclusions：Panasonic意见依赖于症状和体征（不测试）的治疗策略的选择。选择治疗以匹配疾病的严重程度和眼睑边缘疾病或泪液分布和清除障碍的存在与不存在。
Purpose: To develop current treatment recommendations for dry eye disease from consensus of expert advice.Methods: Of 25 preselected international specialists on dry eye, 17 agreed to participate in a modified, 2-round Delphi panel approach. Based on available literature and standards of care, a survey was presented to each panelist. A two-thirds majority was used for consensus building from responses obtained. Treatment algorithms were created. Treatment recommendations for different types and severity levels of dry eye disease were the main outcome.Results: A new term for dry eye disease was proposed: dysfunctional tear syndrome (DTS). Treatment recommendations were based primarily on patient symptoms and signs. Available diagnostic tests were considered of secondary importance in guiding therapy. Development of algorithms was based on the presence or absence of lid margin disease and disturbances of tear distribution and clearance. Disease severity was considered the most important factor for treatment decision-making and was categorized into 4 levels. Severity was assessed on the basis of tear substitute requirements, symptoms of ocular discomfort, and visual disturbance. Clinical signs present in lids, tear film, conjunctiva, and cornea were also used for categorization of severity. Consensus was reached on treatment algorithms for DTS with and without concurrent lid disease.Conclusion: Panelist opinion relied on symptoms and signs (not tests) for selection of treatment strategies. Therapy is chosen to match disease severity and presence versus absence of lid margin disease or tear distribution and clearance disturbances.