RESUMO
Tear film hyperosmolarity plays a core role in the development of dry eye disease (DED) by mediating the disruption of ocular surface homeostasis and triggering inflammation in ocular surface epithelium. In this study, the mechanisms involving the hyperosmolar microenvironment, glycolysis mediating metabolic reprogramming, and pyroptosis were explored clinically, in vitro, and in vivo. Data from DED clinical samples indicated that the expression of glycolysis and pyroptosis-related genes, including PKM2 and GSDMD, was significantly upregulated and that the secretion of IL-1β significantly increased. In vitro, the indirect coculture of macrophages derived from THP-1 and human corneal epithelial cells (HCECs) was used to discuss the interaction among cells. The hyperosmolar environment was found to greatly induce HCECs' metabolic reprogramming, which may be the primary cause of the subsequent inflammation in macrophages upon the activation of the related gene and protein expression. 2-Deoxy-d-glucose (2-DG) could inhibit the glycolysis of HCECs and subsequently suppress the pyroptosis of macrophages. In vivo, 2-DG showed potential efficacy in relieving DED activity and could significantly reduce the overexpression of genes and proteins related to glycolysis and pyroptosis. In summary, our findings suggested that hyperosmolar-induced glycolytic reprogramming played an active role in promoting DED inflammation by mediating pyroptosis.
RESUMO
In recent years, corneal neuralgia in dry eye patients has received more and more clinical attention.Corneal neuralgia refers to the increasing pain of cornea in response to normal painless stimuli, which has a serious negative effect on patients' work and daily life.Corneal neuralgia is often one of the common symptoms of dry eye.Dry eye can also cause corneal sensation decline and the mechanism is still unclear.Patients with dry eye often exhibit structural and functional changes in ocular surface nerve, so understanding the mechanism of dry eye-related neurological abnormalities will help to treat and prevent dry eye-related neurological abnormalities.Various factors such as instability of tear film, abnormal tear secretion, ocular surface inflammation, and increased osmotic pressure of tear film may be involved in dry eye-associated corneal neuralgia.Clinically, anti-inflammatory therapy, lubricating ocular surface, promoting regeneration of corneal nerve fibers, analgesic therapy targeting receptors, palpebral edge treatment, and systemic intervention if necessary are mainly performed based on the pathogenesis of dry eye related corneal neuralgia.In this article, the pathologic and influencing factors of corneal neuralgia were summarized, and the pathogenesis of dry eye-related corneal neuralgia were investigated to help the clinical diagnosis and treatment of dry eye-related corneal neuralgia.
RESUMO
As a P2Y 2 receptor agonist, Diquafosol used as a 3% solution can promote tear fluid and mucin secretion and accelerate the healing of corneal and conjunctival epithelium.It fills an unmet need in ophthalmology in China for the treatment of corneal and conjunctival epithelium injury caused by aqueous solutions and mucin deficiency.This article reviews the mechanisms of 3% Diquafosol in the healing of corneal and conjunctival epithelial damage, hoping to provide a theoretical basis for clinical practice.
RESUMO
With the popularity of cataract and refractive surgery, especially the increasing implantation of advanced technology lens implants, dry eye significantly affects image quality.In 2017, the Asia-Pacific Association of Cataract and Refractive Surgeons (APACRS) produced the new Principles of Preferred Practice for the Management of the Ocular Surface in Cataract and Refractive surgery (hereafter referred to as the PPP). This document provides detailed evidence-based discussions on the incidence rate, pathogenesis, diagnosis, evaluation, clinical symptoms, and treatment of dry eyes during perioperative period of refractive surgery and cataract surgery.The article which interpreted the PPP is aimed to remind general ophthalmologists to pay more attention to the dry eye in cataract and refractive surgery, and make the management of the ocular surface more standardized.
RESUMO
An expert consensus about the clinical diagnosis and treatment of dry eye was documented in 2013 by a corneal expert group of Chinese Ophthalmological Society.However, due to the rapid development of diagnostic and therapeutic devices of dry eye, researoh on dry eye has made significont progress in China since then.Consequently, the existing expert consensus cannot meet the needs of clinical practice.It is therefore urgent to develop a series of standardized diagnosis and treatment protocols, and publish a new consensus of experts and an operating guideline.At the same time, basic, clinical, and translational research on dry eye should be promoted to provide better services to the patients with dry eyes.On January 12, 2019 many experts in the field of dry eye in China held a panel discussion of dry eye study in Guangzhou to analyze the current development status and trends in the field of dry eye in China and abroad.In that meeting, opinions and recommendations were put forward based on a new understanding of the definition of dry eye, new concepts of dysfunctional dry eye, advances its diagnosis and classification, refinement and standardization of dry eye treatment, and the future development of dry eye research.
RESUMO
Dry eye is an ocular surface disease caused by multiple factors,which is characterized by imbalance of tear film homeostasis,changes of ocular surface micro-environments and ocular uncomfortable symptoms.Tear film instability,tear hyperosmolarity,ocular surface inflammation and damage and corneal neurosensory abnormalities play etiological roles in the process of dry eye.Dry eye seriously affects work and life quality of the patients.With the progress of science and technology,the treatment of dry eye is becoming more diversified.The therapeutic methods are different for mild,moderate and serous dry eye.The choice of therapies actually depends on the individual state and condition of therapeutic institutions.A systemic,standardized and comprehensive therapy is associated with the improvement of treatment outcome.This article systematically summarizes the traditional and emerging treatments of dry eye,which are clinically feasible and can provide reference for choosing treatment methods.