Aapola Ulla, Mosallaei Paula, Nättinen Janika, Suurkuukka Ilona, Tuomilehto Jaakko, Keinänen-Kiukaanniemi Sirkka, Saramies Jouko, Uusitalo Hannu
Eye and Vision Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Finnish Register of Visual Impairment, Helsinki, Finland.
Qual Life Res. 2025 May;34(5):1363-1376. doi: 10.1007/s11136-025-03907-0. Epub 2025 Jan 28.
To assess the relationship between quality of life (QoL) and ocular surface health within a Finnish population-based cohort.
A cross-sectional study involved 601 individuals born between the years 1933-1956. Ocular surface health and dry eye disease (DED) were clinically evaluated using several diagnostic tests. Participants completed the Ocular Surface Disease Index (OSDI), QoL assessment with the 15D and Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), and the Beck's Depression Inventory (BDI-II) questionnaires. Various statistical methods were employed to explore the associations between QoL, ocular surface health, and sex disparities.
DED had negative impact on QoL in all participants, and especially in women. Adjusted for comorbidities, DED doubled the odds of worse health-related QoL (15D: OR = 2.31 [95% CI: 1.24-4.31, p < 0.01]) and mental health (SF-36 MCS and BDI-II: OR = 2.08 [95% CI: 1.04-4.16, p < 0.05]). Noninvasive tear break-up time (NIBUT) correlated with all QoL scores. In women, the most significant clinical signs correlating with low QoL were NIBUT (15D: r = 0.20, p = 0.002; SF-36 MCS: r = 0.18, p = 0.026), and conjunctival staining (15D: r=-0.19, p = 0.004; BDI-II: r = 0.27, p < 0.001), whereas in men, blepharitis correlated with depression score (BDI-II: r = 0.20, p = 0.036). High OSDI was associated with worse QoL in women, but not in men.
This first population-based study assessing general QoL data with objective clinical measures of DED indicated that among elderly population, both symptoms and signs of DED independently impacted different aspects of QoL. In addition, significant sex-differences in these associations were observed and should be considered both in research settings and when assessing and treating people with DED.
评估芬兰基于人群的队列中生活质量（QoL）与眼表健康之间的关系。
一项横断面研究纳入了601名出生于1933年至1956年之间的个体。使用多种诊断测试对眼表健康和干眼疾病（DED）进行临床评估。参与者完成了眼表疾病指数（OSDI）、15D生活质量评估、医学结局研究36项简短健康调查（SF - 36）以及贝克抑郁量表（BDI - II）问卷。采用多种统计方法探讨生活质量、眼表健康和性别差异之间的关联。
DED对所有参与者的生活质量都有负面影响，对女性的影响尤为明显。在调整合并症后，DED使与健康相关的生活质量变差（15D：OR = 2.31 [95% CI：1.24 - 4.31，p < 0.01]）以及心理健康变差（SF - 36 MCS和BDI - II：OR = 2.08 [95% CI：1.04 - 4.16，p < 0.05]）的几率增加了一倍。非侵入性泪膜破裂时间（NIBUT）与所有生活质量评分相关。在女性中，与低生活质量相关的最显著临床体征是NIBUT（15D：r = 0.20，p = 0.002；SF - 36 MCS：r = 0.18，p = 0.026）和结膜染色（15D：r = - 0.19，p = 0.004；BDI - II：r = 0.27，p < 0.001），而在男性中，睑缘炎与抑郁评分相关（BDI - II：r = 0.20，p = 0.036）。高OSDI与女性较差的生活质量相关，但与男性无关。
这项首次基于人群的研究通过DED的客观临床测量来评估总体生活质量数据，表明在老年人群中，DED的症状和体征均独立影响生活质量的不同方面。此外，观察到这些关联存在显著的性别差异，在研究环境以及评估和治疗DED患者时均应予以考虑。
