甲状腺相关眼病干眼发病机制研究进展  

Research advances in the pathogenesis of dry eye in thyroid associated ophthalmopathy

作　　者：马云柯 刘一昀 周一凡 马佰凯 孙彤 段虹宇 王毅[1] 齐虹[1] Ma Yunke;Liu Yiyun;Zhou Yifan;Ma Baikai;Sun Tong;Duan Hongyu;Wang Yi;Qi Hong(Department of Ophthalmology,Peking University Third Hospital,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve,Beijing 100191,China)

机构地区：[1]北京大学第三医院眼科,眼部神经损伤的重建保护与康复北京市重点实验室,北京100191

出　　处：《中华眼科杂志》2025年第2期156-160,共5页Chinese Journal of Ophthalmology

基　　金：国家自然科学基金面上项目(82371026,82171022)。

摘　　要：甲状腺相关眼病(TAO)是成人中最为常见的眼眶疾病。眼表疾病是致使TAO患者产生眼部不适感的最普遍原因,严重影响了患者的生活质量。其眼表损伤的表现多样,包括干眼、结膜充血、水肿、暴露性角膜炎、浅层点状角膜病变以及上方角膜缘角膜结膜炎等,其中干眼的发生率居首。TAO干眼的发病机制颇为复杂。除了眼球突出及眼睑退缩等解剖结构变化导致眼表暴露之外,近年来,越来越多的研究表明泪腺免疫性损伤、睑板腺结构与功能异常、眼表慢性炎性反应等眼表微环境损伤也参与到了其发病过程之中。本文针对TAO患者的眼表改变以及其干眼发病机制的最新研究进展予以综述,期望为TAO干眼的临床治疗提供助力。Thyroid-associated ophthalmopathy(TAO)is the most common orbital disease in adults.Ocular surface diseases are the most common cause of ocular discomfort in patients with TAO,seriously affecting the quality of life of patients.The manifestations of ocular surface damage include dry eye,conjunctival congestion,edema,exposure keratitis,superficial punctate keratopathy and superior limbal keratoconjunctivitis,among which the incidence of dry eye is the highest.The pathogenesis of dry eye in TAO is rather complex.In addition to the exposure of the ocular surface caused by anatomical changes such as proptosis and eyelid retraction,in recent years,an increasing number of studies have indicated that ocular surface microenvironmental damages such as immune injury of the lacrimal gland,abnormal structure and function of meibomian glands,and chronic ocular surface inflammation are also involved in its pathogenesis.This article reviews the latest research progress on the ocular surface changes in patients with TAO and the pathogenesis of its dry eye,hoping to provide assistance for the clinical treatment of dry eye in TAO.

关 键 词：GRAVES眼病 干眼综合征 眼表现 眼疾病 

分 类 号：R581[医药卫生—内分泌] R777.34[医药卫生—内科学]