Environmental Effects on Dry Eyes in Primary Sjogren's Syndrome

Abstract

Purpose: To investigate the effects of humidity, temperature, and fine particulate matter (PM<sub>2.5</sub>) on dry eye disease (DED) parameters in primary Sjogren's syndrome patients.Methods: We retrospectively analyzed the medical records of 18 primary Sjogren's syndrome patients who underwent DED treatment and had more than two follow-up visits. Symptom Assessment in Dry Eye (SANDE) scores, tear secretion, tear film breakup times, ocular surface staining scores, and tear osmolarity were assessed. Temperature, humidity, and PM<sub>2.5</sub> concentrations during the week before the patient visits were calculated using public data and their relationships with DED parameters were analyzed.Results: All patients were females, with an average age of 57.6 ± 12.4 years. High temperature was significantly correlated with humidity and PM<sub>2.5</sub> concentration (<i>p</i> = 0.004 and = 0.006, respectively). The high humidity, high temperature, and low PM<sub>2.5</sub> groups had lower SANDE scores (<i>p</i> = 0.017, = 0.063, and = 0.049, respectively) and tear osmolarity (<i>p</i> < 0.001, = 0.009, and < 0.001, respectively). Multiple regression analysis showed that temperature and humidity had stronger correlations with tear osmolarity (<i>p</i> = 0.005 and = 0.012, respectively) compared to PM<sub>2.5</sub> concentrations.Conclusions: Ocular discomfort and tear osmolarity were correlated with temperature, humidity, and PM<sub>2.5</sub> concentrations. Among the DED parameters, tear osmolarity was the most sensitive indicator of exposure to environmental factors.