Non-invasive objective and contemporary methods for measuring ocular surface inflammation in soft contact lens wearers - A review.
Non-invasive objective and contemporary methods for measuring ocular surface inflammation in soft contact lens wearers - A review.
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DOI：
10.1016/j.clae.2017.05.008
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发表时间：
2017-10
期刊：
影响因子：
--
通讯作者：
Gokhale M
中科院分区：
文献类型：
--
作者：
Chao C;Richdale K;Jalbert I;Doung K;Gokhale M
隐形眼镜佩戴是眼表炎症发生的主要危险因素之一。本文的目的是检查和总结现有的关于隐形眼镜相关的眼表炎症机制的知识，以及现有测量眼表炎症的客观方法的有效性的证据。由于机械、化学、缺氧应激或微生物及其毒素的引入，隐形眼镜佩戴被认为会引发眼表炎症反应。除了传统的眼表肿胀、水肿、红肿、发热等炎症征象外，测量眼表亚临床水平炎症的方法还包括泪液炎症介质浓度、结膜细胞形态、角膜上皮树突状细胞密度和形态。在佩戴隐形眼镜期间，泪液炎症介质浓度升高或降低，是否存在相关的炎症事件。佩戴隐形眼镜时结膜细胞化生较高，但杯状细胞密度的变化尚无定论。在软性隐形眼镜佩戴后，树突状细胞密度增加。佩戴隐形眼镜对角膜和结膜（包括擦盖区）树突状细胞迁移的长期影响需要进一步研究。目前正在研究患者因素，如年龄、吸烟、全身性疾病和遗传特征。更好地了解这些机制可能有助于开发新的管理方案和策略，以尽量减少与隐形眼镜佩戴相关的眼表炎症。
Contact lens wear is one of the primary risk factors for the development of ocular surface inflammatory events. The purpose of this review is to examine and summarize existing knowledge on the mechanisms of contact lens related ocular surface inflammation and the evidence for the effectiveness of current objective methods to measure ocular surface inflammation. Contact lens wear is postulated to trigger an inflammatory response on the ocular surface due to mechanical, chemical, hypoxic stress, or by the introduction of microbes and their toxins. Apart from the traditional signs of inflammation, such as swelling, oedema, redness and heat, on the ocular surface, other methods to measure ocular surface inflammation in sub-clinical levels include tear inflammatory mediator concentrations, conjunctival cell morphology, and corneal epithelial dendritic cell density and morphology. Tear inflammatory mediator concentrations are up- or down-regulated during contact lens wear, with or without the presence of associated inflammatory events. There is higher conjunctival cell metaplasia observed with contact lens wear, but changes in goblet cell density are inconclusive. Dendritic cell density is seen to increase soon after initiating soft contact lens wear. The long term effects of contact lens wear on dendritic cell migration in the cornea and conjunctiva, including the lid wiper area, require further investigation. Currently patient factors, such as age, smoking, systemic diseases and genetic profile are being studied. A better understanding of these mechanisms may facilitate the development of new management options and strategies to minimize ocular surface inflammation related to contact lens wear.
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