Purpose

Characteristics of periodic flares of dry eye disease (DED) are not well understood. We conducted a rapid evidence assessment to identify evidence for and characteristics of DED flares.

Methods

Literature searches were performed in Embase® via Ovid®, MEDLINE®, and PubMed®. Clinical trials and observational studies published 2009–2019 were included if they investigated patients aged ≥18 years with clinically diagnosed DED who experienced a flare, defined as a temporary or transient episode of increased ocular discomfort, typically lasting days to a few weeks. Triggers of flares, patient-reported outcomes (symptoms), clinician-measured outcomes (signs), and changes in tear molecules were captured.

Results

Twenty-one publications that included 22 studies met inclusion criteria. Five observational studies described evidence of DED flares in daily life, 5 studies reported changes following cataract/refractive surgery in patients with preoperative DED, and 12 studies employed controlled environment (CE) models. Real-world triggers of DED flares included air conditioning, wind, reading, low humidity, watching television, and pollution. CE chambers (dry, moving air) and surgery also triggered DED flares. Exacerbations of symptoms and signs of DED, assessed through varied measures, were reported during flares. Across studies, matrix metalloproteinase-9 and interleukin-6 increased and epidermal growth factor decreased during DED flares.

Conclusions

Evidence from 22 studies identified triggers and characteristics of DED flares. Further research is needed to assist clinicians in early diagnosis and treatment of patients experiencing flares.

中文翻译：

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干眼症发作：快速证据评估

目的

干眼病 (DED) 周期性发作的特征尚不清楚。我们进行了快速证据评估，以确定 DED 耀斑的证据和特征。

方法

通过 Ovid®、MEDLINE® 和 PubMed® 在 Embase® 中进行文献检索。如果 2009-2019 年发表的临床试验和观察性研究调查了 18 岁以上临床诊断为 DED 的患者，这些患者经历了耀斑，定义为眼部不适感增加的暂时或短暂发作，通常持续数天至数周，则纳入这些临床试验和观察性研究。捕获了耀斑的触发因素、患者报告的结果（症状）、临床医生测量的结果（迹象）和泪液分子的变化。

结果

包括 22 项研究的 21 篇出版物符合纳入标准。五项观察性研究描述了日常生活中 DED 发作的证据，5 项研究报告了术前 DED 患者白内障/屈光手术后的变化，12 项研究采用了受控环境 (CE) 模型。DED 耀斑的真实触发因素包括空调、风、阅读、低湿度、看电视和污染。CE 室（干燥、流动的空气）和手术也引发了 DED 耀斑。在耀斑期间报告了通过各种措施评估的 DED 症状和体征的恶化。在整个研究中，基质金属蛋白酶 9 和白细胞介素 6 在 DED 发作期间增加而表皮生长因子减少。

结论

来自 22 项研究的证据确定了 DED 耀斑的触发因素和特征。需要进一步的研究来协助临床医生对出现耀斑的患者进行早期诊断和治疗。