RT Journal Article
SR Electronic
T1 Towards a dynamic customised therapy for ocular surface dysfunctions
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 955
OP 960
DO 10.1136/bjophthalmol-2012-302568
VO 97
IS 8
A1 Pasquale Aragona
A1 Maurizio Rolando
YR 2013
UL http://bjo.bmj.com/content/97/8/955.abstract
AB The ocular surface is a highly dynamic system characterised by continuous adaptive reactions to environmental, toxic, infective, traumatic and inflammatory conditions that interfere with its homeostasis. When the adaptive response is not able to cope with environmental or internal aggressions, a persisting dysfunction may develop into a self-maintaining vicious cycle, thereby developing a chronic disease. This process is not even, but characterised by cycles of worsening and improvement accompanied by morphofunctional changes of the ocular surface structure. The therapy for this condition cannot be unique and stable all along the course of the disease, but should be adapted to the modifications occurring on the ocular surface. It should be long term and dynamic, in order to be tailored on each patient's conditions. An ideal therapeutic strategy should address simultaneously the main targets: tear film quality and stability, morphofunctional changes of the epithelia, the obvious and subclinical inflammation, and the structural and functional changes of nerves. The avoidance of schematic approaches and the customisation of the therapy, modified according to the disease presentation, will be highly desirable and will open to a patient-oriented approach, granting a more prompt and stable improvement of the ocular surface with better-tolerated therapies.