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定义干眼疾病中迹象和症状之间的不一致:干眼评估和管理 (DREAM) 研究的见解

Karen Matar¹, Yinxi Yu², Patrick Augello³

¹Cole Eye Institute, and eDepartment of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, USA.

American journal of ophthalmology

|February 26, 2026

概括

干眼疾病 (DED) 的症状-征兆不一致是常见的和复杂的. 不同的分析方法揭示了不同的不一致模式,有助于有针对性的DED患者管理和治疗策略.

科学领域:

眼科医生眼科眼科
临床研究临床研究
患者的治疗结果.

背景情况:

干眼病 (DED) 的诊断和管理因症状与征兆不一致而复杂化.
了解不一致的患病率和预测因素对于有效的患者护理至关重要.

研究的目的:

通过使用三个不同的分析框架,评估DED中的症状-征兆不一致性.
在一个大规模的前性队列中识别不一致性相关的系统性风险因素.

主要方法:

多中心随机干眼评估和管理 (DREAM) 研究队列的二次分析 (n=535) 具有中度至重度的DED.
通过基于等级的比较,基于不适的分类 (BODI) 和一种新的时间方法 (3-12个月) 评估不一致.
多变量回归确定了不一致的预测因素.

主要成果:

77%的患者使用基于等级的方法表现出不一致;症状主导的不一致与年轻年龄和不适有关.
标志主导异调在Sjögren综合征患者中更为常见.
不适与症状有很强的相关性,但与迹象有很弱的相关性.
46%的患者在9个月内有不一致的症状-征兆轨迹;抗抑郁药的使用与一致性相关.

结论:

在DED中,症状-征兆不一致性是普遍的,多因素的和持久的.
将三种不同的分类方法进行比较具有独特的临床实用性.
基于不一致模式的DED患者的分层可以改善治疗和转诊策略.

关键词:

临床试验临床试验不和不和不和不和干眼疾病干眼疾病眼部的不适眼部的不适眼睛的症状和迹象.

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