Clinical Guidelines for Management of Dry Eye Associated with Sjogren Disease
Clinical Guidelines for Management of Dry Eye Associated with Sjogren Disease
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DOI：
10.1016/j.jtos.2014.12.001
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发表时间：
2015-04-01
期刊：
影响因子：
6.4
通讯作者：
Jacobs, Deborah S.
中科院分区：
文献类型：
--
作者：
Foulks, Gary N.;Forstot, S. Lance;Jacobs, Deborah S.
目的：通过评价已发表的治疗方法并推荐治疗方案，为干燥综合征相关性干眼病的治疗提供共识临床指南。设计：对已报道的干眼病治疗方法的共识小组评价。研究方法：以2007年国际干眼研讨会（DEWS）报告为起点，一个由眼科护理提供者和顾问组成的小组评估了同行评审的出版物，并制定了评估和管理与干燥综合征相关的干眼疾病的建议。根据美国眼科学会首选实践模式指南的证据等级对出版物进行分级。推荐强度根据推荐评估、发展和评价（GRADE）指南分级。结果：小组的建议简要总结如下。评估应包括不适和视力障碍的症状，以及确定水产生不足和泪液量蒸发损失的相对贡献。泪膜稳定性、泪液渗透压、眼睑边缘病变程度和眼表损伤等客观参数应用于对干眼症的严重程度进行分期，以帮助选择适当的治疗方案。对患者进行有关问题性质、加重因素和治疗目标的教育对成功管理至关重要。泪液补充和稳定、控制泪腺和眼表炎症以及可能刺激泪液产生是根据干眼病的特征和严重程度使用的治疗选择。摘要：介绍了与干燥综合症相关的干眼症的管理指南。
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.