TFOS DEWS II pathophysiology report.
Identifieur interne : 000309 ( Main/Exploration ); précédent : 000308; suivant : 000310TFOS DEWS II pathophysiology report.
Auteurs : Anthony J. Bron [Royaume-Uni] ; Cintia S. De Paiva [États-Unis] ; Sunil K. Chauhan [États-Unis] ; Stefano Bonini [Italie] ; Eric E. Gabison [France] ; Sandeep Jain [États-Unis] ; Erich Knop [Allemagne] ; Maria Markoulli [Australie] ; Yoko Ogawa [Japon] ; Victor Perez [États-Unis] ; Yuichi Uchino [Japon] ; Norihiko Yokoi [Japon] ; Driss Zoukhri [États-Unis] ; David A. Sullivan [États-Unis]Source :
- The ocular surface [ 1937-5913 ] ; 2017.
Abstract
The TFOS DEWS II Pathophysiology Subcommittee reviewed the mechanisms involved in the initiation and perpetuation of dry eye disease. Its central mechanism is evaporative water loss leading to hyperosmolar tissue damage. Research in human disease and in animal models has shown that this, either directly or by inducing inflammation, causes a loss of both epithelial and goblet cells. The consequent decrease in surface wettability leads to early tear film breakup and amplifies hyperosmolarity via a Vicious Circle. Pain in dry eye is caused by tear hyperosmolarity, loss of lubrication, inflammatory mediators and neurosensory factors, while visual symptoms arise from tear and ocular surface irregularity. Increased friction targets damage to the lids and ocular surface, resulting in characteristic punctate epithelial keratitis, superior limbic keratoconjunctivitis, filamentary keratitis, lid parallel conjunctival folds, and lid wiper epitheliopathy. Hybrid dry eye disease, with features of both aqueous deficiency and increased evaporation, is common and efforts should be made to determine the relative contribution of each form to the total picture. To this end, practical methods are needed to measure tear evaporation in the clinic, and similarly, methods are needed to measure osmolarity at the tissue level across the ocular surface, to better determine the severity of dry eye. Areas for future research include the role of genetic mechanisms in non-Sjögren syndrome dry eye, the targeting of the terminal duct in meibomian gland disease and the influence of gaze dynamics and the closed eye state on tear stability and ocular surface inflammation.
DOI: 10.1016/j.jtos.2017.05.011
PubMed: 28736340
Affiliations:
- Allemagne, Australie, France, Italie, Japon, Royaume-Uni, États-Unis
- Angleterre, Berlin, Floride, Illinois, Latium, Massachusetts, Nouvelle-Galles du Sud, Oxfordshire, Région de Kantō, Texas, Île-de-France
- Berlin, Chicago, Oxford, Paris, Rome, Sydney, Tokyo
- Université d'Oxford, Université de l'Illinois à Chicago
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Universitätsmedizin Berlin, Berlin, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Departments of Cell and Neurobiology and Ocular Surface Center Berlin, Charité - Universitätsmedizin Berlin, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Markoulli, Maria" sort="Markoulli, Maria" uniqKey="Markoulli M" first="Maria" last="Markoulli">Maria Markoulli</name><affiliation wicri:level="3"><nlm:affiliation>School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>School of Optometry and Vision Science, University of New South Wales, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Ogawa, Yoko" sort="Ogawa, Yoko" uniqKey="Ogawa Y" first="Yoko" last="Ogawa">Yoko Ogawa</name><affiliation wicri:level="3"><nlm:affiliation>Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Ophthalmology, Keio University School of Medicine, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Perez, Victor" sort="Perez, Victor" uniqKey="Perez V" first="Victor" last="Perez">Victor Perez</name><affiliation wicri:level="2"><nlm:affiliation>Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Uchino, Yuichi" sort="Uchino, Yuichi" uniqKey="Uchino Y" first="Yuichi" last="Uchino">Yuichi Uchino</name><affiliation wicri:level="3"><nlm:affiliation>Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Ophthalmology, Keio University School of Medicine, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Yokoi, Norihiko" sort="Yokoi, Norihiko" uniqKey="Yokoi N" first="Norihiko" last="Yokoi">Norihiko Yokoi</name><affiliation wicri:level="1"><nlm:affiliation>Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto</wicri:regionArea><wicri:noRegion>Kyoto</wicri:noRegion></affiliation></author><author><name sortKey="Zoukhri, Driss" sort="Zoukhri, Driss" uniqKey="Zoukhri D" first="Driss" last="Zoukhri">Driss Zoukhri</name><affiliation wicri:level="2"><nlm:affiliation>Tufts University School of Dental Medicine, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Tufts University School of Dental Medicine, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Sullivan, David A" sort="Sullivan, David A" uniqKey="Sullivan D" first="David A" last="Sullivan">David A. 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Bron</name><affiliation wicri:level="4"><nlm:affiliation>Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK. Electronic address: anthony.bron@eye.ox.ac.uk.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Vision and Eye Research Unit, Anglia Ruskin University, Cambridge</wicri:regionArea><orgName type="university">Université d'Oxford</orgName><placeName><settlement type="city">Oxford</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="De Paiva, Cintia S" sort="De Paiva, Cintia S" uniqKey="De Paiva C" first="Cintia S" last="De Paiva">Cintia S. De Paiva</name><affiliation wicri:level="2"><nlm:affiliation>Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Ophthalmology, Baylor College of Medicine, Houston, TX</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Chauhan, Sunil K" sort="Chauhan, Sunil K" uniqKey="Chauhan S" first="Sunil K" last="Chauhan">Sunil K. Chauhan</name><affiliation wicri:level="2"><nlm:affiliation>Schepens Eye Research Institute & Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Schepens Eye Research Institute & Massachusetts Eye and Ear, Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Bonini, Stefano" sort="Bonini, Stefano" uniqKey="Bonini S" first="Stefano" last="Bonini">Stefano Bonini</name><affiliation wicri:level="3"><nlm:affiliation>Department of Ophthalmology, University Campus Biomedico, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Ophthalmology, University Campus Biomedico, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Gabison, Eric E" sort="Gabison, Eric E" uniqKey="Gabison E" first="Eric E" last="Gabison">Eric E. Gabison</name><affiliation wicri:level="3"><nlm:affiliation>Department of Ophthalmology, Fondation Ophtalmologique Rothschild & Hôpital Bichat Claude Bernard, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Ophthalmology, Fondation Ophtalmologique Rothschild & Hôpital Bichat Claude Bernard, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Jain, Sandeep" sort="Jain, Sandeep" uniqKey="Jain S" first="Sandeep" last="Jain">Sandeep Jain</name><affiliation wicri:level="4"><nlm:affiliation>Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL</wicri:regionArea><placeName><region type="state">Illinois</region><settlement type="city">Chicago</settlement></placeName><orgName type="university">Université de l'Illinois à Chicago</orgName></affiliation></author><author><name sortKey="Knop, Erich" sort="Knop, Erich" uniqKey="Knop E" first="Erich" last="Knop">Erich Knop</name><affiliation wicri:level="3"><nlm:affiliation>Departments of Cell and Neurobiology and Ocular Surface Center Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Departments of Cell and Neurobiology and Ocular Surface Center Berlin, Charité - Universitätsmedizin Berlin, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Markoulli, Maria" sort="Markoulli, Maria" uniqKey="Markoulli M" first="Maria" last="Markoulli">Maria Markoulli</name><affiliation wicri:level="3"><nlm:affiliation>School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>School of Optometry and Vision Science, University of New South Wales, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Ogawa, Yoko" sort="Ogawa, Yoko" uniqKey="Ogawa Y" first="Yoko" last="Ogawa">Yoko Ogawa</name><affiliation wicri:level="3"><nlm:affiliation>Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Ophthalmology, Keio University School of Medicine, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Perez, Victor" sort="Perez, Victor" uniqKey="Perez V" first="Victor" last="Perez">Victor Perez</name><affiliation wicri:level="2"><nlm:affiliation>Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Uchino, Yuichi" sort="Uchino, Yuichi" uniqKey="Uchino Y" first="Yuichi" last="Uchino">Yuichi Uchino</name><affiliation wicri:level="3"><nlm:affiliation>Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Ophthalmology, Keio University School of Medicine, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Yokoi, Norihiko" sort="Yokoi, Norihiko" uniqKey="Yokoi N" first="Norihiko" last="Yokoi">Norihiko Yokoi</name><affiliation wicri:level="1"><nlm:affiliation>Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto</wicri:regionArea><wicri:noRegion>Kyoto</wicri:noRegion></affiliation></author><author><name sortKey="Zoukhri, Driss" sort="Zoukhri, Driss" uniqKey="Zoukhri D" first="Driss" last="Zoukhri">Driss Zoukhri</name><affiliation wicri:level="2"><nlm:affiliation>Tufts University School of Dental Medicine, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Tufts University School of Dental Medicine, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Sullivan, David A" sort="Sullivan, David A" uniqKey="Sullivan D" first="David A" last="Sullivan">David A. Sullivan</name><affiliation wicri:level="2"><nlm:affiliation>Schepens Eye Research Institute & Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Schepens Eye Research Institute & Massachusetts Eye and Ear, Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author></analytic><series><title level="j">The ocular surface</title><idno type="eISSN">1937-5913</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The TFOS DEWS II Pathophysiology Subcommittee reviewed the mechanisms involved in the initiation and perpetuation of dry eye disease. Its central mechanism is evaporative water loss leading to hyperosmolar tissue damage. Research in human disease and in animal models has shown that this, either directly or by inducing inflammation, causes a loss of both epithelial and goblet cells. The consequent decrease in surface wettability leads to early tear film breakup and amplifies hyperosmolarity via a Vicious Circle. Pain in dry eye is caused by tear hyperosmolarity, loss of lubrication, inflammatory mediators and neurosensory factors, while visual symptoms arise from tear and ocular surface irregularity. Increased friction targets damage to the lids and ocular surface, resulting in characteristic punctate epithelial keratitis, superior limbic keratoconjunctivitis, filamentary keratitis, lid parallel conjunctival folds, and lid wiper epitheliopathy. Hybrid dry eye disease, with features of both aqueous deficiency and increased evaporation, is common and efforts should be made to determine the relative contribution of each form to the total picture. To this end, practical methods are needed to measure tear evaporation in the clinic, and similarly, methods are needed to measure osmolarity at the tissue level across the ocular surface, to better determine the severity of dry eye. Areas for future research include the role of genetic mechanisms in non-Sjögren syndrome dry eye, the targeting of the terminal duct in meibomian gland disease and the influence of gaze dynamics and the closed eye state on tear stability and ocular surface inflammation.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>France</li><li>Italie</li><li>Japon</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Berlin</li><li>Floride</li><li>Illinois</li><li>Latium</li><li>Massachusetts</li><li>Nouvelle-Galles du Sud</li><li>Oxfordshire</li><li>Région de Kantō</li><li>Texas</li><li>Île-de-France</li></region><settlement><li>Berlin</li><li>Chicago</li><li>Oxford</li><li>Paris</li><li>Rome</li><li>Sydney</li><li>Tokyo</li></settlement><orgName><li>Université d'Oxford</li><li>Université de l'Illinois à Chicago</li></orgName></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Bron, Anthony J" sort="Bron, Anthony J" uniqKey="Bron A" first="Anthony J" last="Bron">Anthony J. Bron</name></region></country><country name="États-Unis"><region name="Texas"><name sortKey="De Paiva, Cintia S" sort="De Paiva, Cintia S" uniqKey="De Paiva C" first="Cintia S" last="De Paiva">Cintia S. De Paiva</name></region><name sortKey="Chauhan, Sunil K" sort="Chauhan, Sunil K" uniqKey="Chauhan S" first="Sunil K" last="Chauhan">Sunil K. Chauhan</name><name sortKey="Jain, Sandeep" sort="Jain, Sandeep" uniqKey="Jain S" first="Sandeep" last="Jain">Sandeep Jain</name><name sortKey="Perez, Victor" sort="Perez, Victor" uniqKey="Perez V" first="Victor" last="Perez">Victor Perez</name><name sortKey="Sullivan, David A" sort="Sullivan, David A" uniqKey="Sullivan D" first="David A" last="Sullivan">David A. Sullivan</name><name sortKey="Zoukhri, Driss" sort="Zoukhri, Driss" uniqKey="Zoukhri D" first="Driss" last="Zoukhri">Driss Zoukhri</name></country><country name="Italie"><region name="Latium"><name sortKey="Bonini, Stefano" sort="Bonini, Stefano" uniqKey="Bonini S" first="Stefano" last="Bonini">Stefano Bonini</name></region></country><country name="France"><region name="Île-de-France"><name sortKey="Gabison, Eric E" sort="Gabison, Eric E" uniqKey="Gabison E" first="Eric E" last="Gabison">Eric E. Gabison</name></region></country><country name="Allemagne"><region name="Berlin"><name sortKey="Knop, Erich" sort="Knop, Erich" uniqKey="Knop E" first="Erich" last="Knop">Erich Knop</name></region></country><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Markoulli, Maria" sort="Markoulli, Maria" uniqKey="Markoulli M" first="Maria" last="Markoulli">Maria Markoulli</name></region></country><country name="Japon"><region name="Région de Kantō"><name sortKey="Ogawa, Yoko" sort="Ogawa, Yoko" uniqKey="Ogawa Y" first="Yoko" last="Ogawa">Yoko Ogawa</name></region><name sortKey="Uchino, Yuichi" sort="Uchino, Yuichi" uniqKey="Uchino Y" first="Yuichi" last="Uchino">Yuichi Uchino</name><name sortKey="Yokoi, Norihiko" sort="Yokoi, Norihiko" uniqKey="Yokoi N" first="Norihiko" last="Yokoi">Norihiko Yokoi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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