Kawashima Motoko, Yamada Masakazu, Shigeyasu Chika, Suwaki Kazuhisa, Uchino Miki, Hiratsuka Yoshimune, Yokoi Norihiko, Tsubota Kazuo, For The Decs-J For The Decs-J
Department of Ophthalmology, Keio University School of Medicine, Tokyo 1608582, Japan.
Department of Ophthalmology, Kyorin University School of Medicine, Tokyo 1818611, Japan.
J Clin Med. 2020 Jun 29;9(7):2040. doi: 10.3390/jcm9072040.
We investigated the association between dry eye disease and systemic comorbidities, including dry eye subtype, quality of life (QOL) and health utility among patients with dry eye disease. This cross-sectional, observational study enrolled 449 patients with dry eye disease (386 females; mean age, 62.6 ± 15.7 [range, 21-90] years). Ophthalmic examination findings included tear film break-up time (TBUT), Schirmer I value and keratoconjunctival staining score. QOL and health utility were evaluated using the Dry Eye-Related Quality-of-Life Score (DEQS) and Human Utility Index Mark 3 (HUI-3), respectively. Background information, including systemic comorbidities, was obtained. Prevalence of systemic comorbidities was 48.8% (219/449). No significant difference occurred between DEQS and systemic comorbidity. However, patients with dry eye disease and systemic comorbidities (depression and insomnia) exhibited significantly worse ocular surface parameters, particularly regarding TBUT, than those without. Dry eye disease with insomnia or depression comorbidity significantly correlated with friction-related diseases (including conjunctivochalasis or lid wiper epitheliopathy). A high prevalence of several systemic comorbidities occurred in patients with dry eye disease. This study shows an association between ocular signs and systemic comorbidities, particularly depression and insomnia. Ophthalmologists should be aware of patients' systemic comorbidities in the diagnosis and management of dry eye disease.
我们调查了干眼症与全身合并症之间的关联,包括干眼症亚型、生活质量(QOL)以及干眼症患者的健康效用。这项横断面观察性研究纳入了449例干眼症患者(386例女性;平均年龄62.6±15.7[范围21 - 90]岁)。眼科检查结果包括泪膜破裂时间(TBUT)、Schirmer I值和角膜结膜染色评分。分别使用干眼症相关生活质量评分(DEQS)和人类效用指数Mark 3(HUI - 3)评估生活质量和健康效用。获取了包括全身合并症在内的背景信息。全身合并症的患病率为48.8%(219/449)。DEQS与全身合并症之间未发现显著差异。然而,患有干眼症和全身合并症(抑郁症和失眠症)的患者与未患这些疾病的患者相比,眼表参数明显更差,尤其是在TBUT方面。合并失眠症或抑郁症的干眼症与摩擦相关疾病(包括结膜松弛症或睑板擦痕上皮病变)显著相关。干眼症患者中几种全身合并症的患病率较高。这项研究表明眼部体征与全身合并症之间存在关联,尤其是抑郁症和失眠症。眼科医生在干眼症的诊断和管理中应了解患者的全身合并症。