Mai Elsa L C, Lin Chih-Cheng, Lian Iebin, Liao Renhao, Chen Meiling, Chang Chaokai
Far Eastern Memorial Hospital, Taipei, Taiwan, ROC.
Yuanpei University of Medical Technology, Hsinchu, Taiwan, ROC.
Int Ophthalmol. 2019 Dec;39(12):2731-2739. doi: 10.1007/s10792-019-01117-5. Epub 2019 Jul 29.
To investigate the incidence and prevalence of dry eye disease (DED) in Taiwan and to explore its potential risk factors.
Population-based longitudinal data from 2000 to 2013 based on Taiwan National Health Insurance Research Database were used in this study. To explore potential risks factor of interest, patients who had DED diagnosis before the exposure were excluded. Each patient from the exposure and his/her matched non-exposure controls were followed until either the diagnosis of DED or censorship. Kaplan-Meier method was used to compare the hazard of DED between cohorts. Stratified Cox proportional hazard models were applied to estimate the adjusted effect.
The age-adjusted prevalence for men and women were 6.81% and 16.16%, respectively. The age-gender rate of the same period was 549 per 10 person-years. The propensity-adjusted hazard ratio of DED is 1.816 for the presbyopia versus non-presbyopia (with 95% CI = [1.737, 1.897] with p value < 0.0001).
The DED incidence for women peaked at age 50-74, while that for men peaked at age ≧ 75. The incidence in young people seems stable both for women and for men. While exploring the factors of DED, there is a significant association between presbyopia and DED even after matching age/gender and comorbidity conditions. Further clinical studies are needed to justify whether the corrective refractive treatment such as presbyopic glasses to treat the frequently hyperopic status of these patients could be beneficial to both dry eye and presbyopic condition.
调查台湾地区干眼症（DED）的发病率和患病率，并探讨其潜在风险因素。
本研究使用了基于台湾国民健康保险研究数据库的2000年至2013年的人群纵向数据。为了探索感兴趣的潜在风险因素，排除了在暴露前被诊断为DED的患者。对暴露组的每位患者及其匹配的非暴露对照组进行随访，直至诊断为DED或失访。采用Kaplan-Meier方法比较队列之间DED的风险。应用分层Cox比例风险模型估计调整后的效应。
男性和女性的年龄调整患病率分别为6.81%和16.16%。同期的年龄性别发病率为每10人年549例。老花眼与非老花眼的DED倾向调整风险比为1.816（95%CI = [1.737, 1.897]，p值<0.0001）。
女性DED发病率在50 - 74岁达到峰值，而男性在75岁及以上达到峰值。年轻人的发病率在男性和女性中似乎都保持稳定。在探索DED的因素时，即使在匹配年龄/性别和合并症情况后，老花眼与DED之间仍存在显著关联。需要进一步的临床研究来证明诸如老花眼镜等矫正屈光治疗对这些患者常见的远视状态进行治疗是否对干眼症和老花眼状况都有益。
