Risk Of Dry Eye Disease Research Articles

A Set of Global Metabolomic Biomarker Candidates to Predict the Risk of Dry Eye Disease

Purpose: We used ultraperformance liquid chromatography coupled with quadrupole/time-of-flight tandem mass spectrometry (UPLC-Q/TOF-MS/MS) to analyze the metabolic profile of reflex tears from patients with dry eye disorders. Methods: We performed a cross-sectional study involving 113 participants: 85 patients diagnosed with dry eye syndrome (dry eye group, DEG) and 28 healthy subjects (control group, CG). Reflex tears (20–30 μl) were collected from the tear meniscus of both eyes of each subject with a Schirmer I test strip. Mass spectrometry data were acquired with a standard workflow by UPLC-Q/TOF-MS/MS. Metabolites were quantitatively analyzed and matched with entries in the Metlin, Massbank and HMDB databases. LASSO regression was conducted to detect important metabolites. Multiple logistic regression was used to find the significant metabolic biomarker candidates for dry eye syndrome. Open database sources, including the KEGG and MetaboAnalyst, were used to identify metabolic pathways. Results: After the LASSO regression and multiple logistic regression analysis, 41 out of 57 metabolic biomarker candidates were significantly correlated with fluorescein breakup time (FBUT), 3 out of 20 with Ocular Surface Disease Index (OSDI) score, and 18 out of 57 with fluorescein staining (FL). Taking the overlap of these three sets, 48 out of 51 metabolites contributed to dry eye incidence. Metabolic pathway analysis revealed that the main pathways were glucose metabolism, amino acid metabolism and glutathione metabolism. Conclusion: Dry eye syndrome induces changes in the tear metabolic profile, which reveals the relationship between changes in metabolites and symptoms of dry eye syndrome. Funding Statement: This study was supported by the Youth project of Shanghai Municipal Commission of Health and Family Planning (grant number 17ZR1427100), the Scientific Research Foundation of Shanghai Municipal Commission of Health and Family Planning (grant number 201840336), the Shanghai Municipal Commission of Health and Family Planning (grant number 20194Y0238), the National Natural Science Foundation of China (grant numbers 81300771), The Project of Key Disciplines of Medicine in Yangpu District of Shanghai (grant number YP16ZA02). Declaration of Interests: The authors declare no conflicts of interest. Ethical Approval Statement: The study was performed in accordance to principles of the Declaration of Helsinki and study protocol were reviewed and approved by the Ethics Committee of Yangpu District Central Hospitial. Informed consent was obtained from each participant enrolled in this study.

Dry Eye Symptoms May Have Association With Psychological Stress in Medical Students.

To evaluate the prevalence and risk factors of symptomatic dry eye disease (DED) among medical students. This cross-sectional study included 209 students at a medical school in Korea. Dry eye symptoms were assessed using a 9-item questionnaire, and DED was defined as having one or more dry eye symptoms often or all the time. The ocular surface disease index (OSDI) and visual analog scale (VAS) questionnaires were also administered to quantify the dry eye symptoms. A survey including demographic data, potential risk factors for DED, personal habits, and psychological stress was also performed. Of the 209 students, 188 (93 men and 95 women) completed the survey. The average age was 28.0±2.5 (mean±SD; range, 23-37) years. Prevalence of DED was 27.1% (51/188). Participants with DED had significantly higher VAS and OSDI than those without DED (P<0.001 for both). Univariate analysis revealed that female sex (P=0.001), contact lens (CL) wear (P=0.034), prolonged computer use (P=0.001), and higher psychological stress score (P<0.001) had significant association with DED. Multivariate analysis also showed the significant association between DED and female sex (P=0.026), CL wear (P=0.042), prolonged computer use (P=0.004), and higher stress score (P=0.014). Symptomatic DED was prevalent among medical students. Increased psychological stress was associated with higher risk of DED. Its risk also increased among women, CL wearers, and prolonged computer users.

Association Between Single Nucleotide Polymorphisms in the Vitamin D Receptor and Incidence of Dry Eye Disease in Chinese Han Population

BackgroundDry eye disease (DED) is a chronic dysfunction of the ocular surface and has become an important public problem. Vitamin D receptor (VDR) gene polymorphism has been found to be associated with different kinds of diseases. The relationship between single nucleotide polymorphisms (SNPs) in the VDR gene should be studied.Material/MethodsIn the present case-control study, we investigated the association of VDR gene polymorphism with DED risk. Clinical data including age, gender, body mass index (BMI, kg/m2), smoking history, diabetes, and blood pressure were recorded. Serum 25-hydroxy vitamin D (25[OH]D) was chosen as the main parameter that reflected the level of vitamin D. We identified SNPs of VDR gene Apa-1, Bsm-1, Fok-1, and Taq-1 in both DED cases and healthy controls.ResultsA total of 124 DED cases and 135 healthy controls were included in this study. It was reported that aa in Apa-1 (OR=2.803, 95% CI, 1.350–5.820) and tt in Taq-1 (OR=0.362, 95% CI, 0.141–0.930) were associated with increased the risk of DED. Analysis of the allele frequencies of VDR gene polymorphisms among DED patients and healthy controls showed that allele differences in Apa-1 were significantly associated with higher risk.ConclusionsSNPs of VDR gene (Apa-1 and Taq-1) were associated with the risk of DED. No significant association of Bsm-1 and Fok-1 in VDR gene demonstrated significant effect in the incidence of DED. Thus, we found that several SNPs of VDR gene could provide significant pathogenic effects in the risk of DED.

Prevalence of dry eye disease in Ontario, Canada: A population-based survey

PurposePopulation-based cross-sectional survey in Ontario to estimate the 2016 prevalence of dry eye disease (DED) and associated risk factors among adults in Canada. MethodsWe emailed the 5-Item Dry Eye Questionnaire (DEQ-5) to 124,469 Ontario adults (age ≥18 years) in the IQVIA E360 database, March–April 2017. Inclusion criteria were: ≥2 visits to an Ontario based clinic, ≥1 visits in the 1 year before the study; database record with email. DED was defined as a DEQ-5 score of >6/22. The crude prevalence by age/sex of the Ontario sample was adjusted to the 2016 Canadian population (mean age 41.0 years, 51% female). Significance of DED risk factors (age, sex, selected diseases/medical conditions and medications) was evaluated by logistic regression analysis. ResultsOf the 5163 (4.1%) patients who completed the survey (59.5% female, median age, 46 years; 40.4% male, 56 years), 1135 respondents reported DED. Prevalence increased with age (p < 0.05) and was highest among those aged 55–64 years (24.7%; 95% CI, 22.1–27.3%) and lowest among those aged 25–34 years (18.4%; 95% CI, 15.9–21.0%). Prevalence was significantly higher (p < 0.001) among women (24.7%; 95% CI, 23.2–26.2%) than men (18.0%; 95% CI, 16.4–19.7%). Other risk factors were not significant. The age-/sex-adjusted Canadian DED prevalence estimate from this sample was 21.3% (95% CI, 19.8–23.2%), corresponding to ∼6.3 million people. ConclusionsBased on the Ontario sample, we estimate that >6 million Canadian adults may have DED, and that older people and females are more likely to be affected.

Gout as a Risk Factor for Dry Eye Disease: A Population-Based Cohort Study.

This study evaluated the effect of gout on the risk of dry eye disease (DED) by using the National Health Insurance Research Database (NHIRD). Data for 30,192 gout patients (21,081 men and 9111 women) and 30,192 non-gout patients (21,005 men and 9187 women) were analyzed. Approximately 1 million patients were randomly sampled from the NHIRD registry. After applying exclusion criteria, patients diagnosed with gout were enrolled in the study group. Thereafter, each individual in the study group underwent the matching process via the propensity score with another non-gout individual, which constituted the control group. The main outcome was defined as the development of DED in accordance with the corresponding International Classification of Diseases, Ninth Revision. In addition to DED, other risk factors including age, sex, and urbanization, and several co-morbidities were included in the multivariate model. The incidence of DED with the adjusted hazard ratio (aHR) and cumulative probability were evaluated in the gout and non-gout patients. A total of 2913 DED events were observed in the study group, whereas 2631 DED events were observed in the control group. A higher incidence rate ratio was found in the study group after adjustment (aHR: 1.065). Moreover, the cumulative probability indicated a significantly increased risk of DED in the study group (p = 0.001). The other potential risk factors of DED according to the multivariate analysis include older age, female gender, higher degree of urbanization, keratopathy, age-related macular degeneration, glaucoma, cataract, ischemic heart disease, hyperlipidemia, peripheral vascular disease, chronic pulmonary disease, rheumatic disease, peptic ulcer disease, liver disease, and malignancy. In conclusion, gout increased the risk of DED after adjustment, and the risk is positively correlated to a longer disease period.

Impact of blinking on ocular surface and tear film parameters

PurposeTo investigate the influence of blinking on tear film parameters, ocular surface characteristics, and dry eye symptomology. MethodsA total of 154 participants were recruited in an age, gender and ethnicity-matched cross-sectional study, of which 77 exhibited clinically detectable incomplete blinking, and 77 did not. Blink rate, dry eye symptomology, tear film parameters, and ocular surface characteristics were assessed in a single clinical session. ResultsOverall, a higher proportion of participants exhibiting incomplete blinking fulfilled the TFOS DEWS II dry eye diagnostic criteria (64% versus 44%, p = 0.02), with an odds ratio (95% CI) of 2.2 (1.2–4.2) times. Participants exhibiting incomplete blinking had higher Ocular Surface Disease Index scores (18 ± 13 versus 12 ± 9, p = 0.01), and greater levels of meibomian gland dropout (41.3 ± 15.7% versus 27.5 ± 14.1%, p < 0.001). Furthermore, poorer tear film lipid layer thickness, non-invasive tear film stability, expressed meibum quality, eyelid notching, and anterior blepharitis grades were also observed in those exhibiting incomplete blinking (all p < 0.05). Blink frequency did not correlate significantly with any ocular surface parameters (all p > 0.05). ConclusionsIncomplete blinking was associated with a two-fold increased risk of dry eye disease. The greater levels of meibomian gland dropout, as well as poorer expressed meibum quality and tear film lipid layer thickness, observed would suggest that incomplete blinking may predispose towards the development of evaporative dry eye.

Prevalence and Risk Factors of Dry Eye Disease in Kuantan, Malaysia

Background: To determine the prevalence of dry eye disease (DED) at Jalan Hospital Eye Care, International Islamic University Malaysia (IIUM), Kuantan, Malaysia. Methods: The dry eye symptoms and tear breakup time test (TBUT) values retrieved from the medical records of 643 patients were retrospectively analysed. Dry eye cases with one or more symptom were included. ‘Yes’ or ‘no’ responses were used in discriminant analysis of tear abnormality (TBUT < 5 seconds). Results: The crude prevalence of DED was 48.5%, the age-adjusted prevalence was 43% in women <50 years of age, and 68.4% in those ≥50 years of age. Contact lens wear and low TBUT values were associated with DED risk in men. Age of ≥50 years and a low tear meniscus height (TMH) score were associated with risk of DED symptoms in women. Conclusions: The prevalence of DED in optometric outpatients at IIUM was relatively high, especially in the elderly population. Symptoms and signs were poorly associated with DED. TBUT performed well in diagnosing dry eye and may be useful to improve the assessment of patients with dry eye problems in this region.

Determination of Risk Factors and Treatment of Dry Eye Disease in Type 1 Diabetes Before Corneal Complications at Sindh Institute of Ophthalmology And Visual Sciences.

Objective:The objective of this study was to assess and determine the risk factors and treatment of dry eye disease in type 1 diabetes before any ocular surface or corneal complication occurs. This study was conducted at Sindh Institute of Ophthalmology And Visual Sciences, Hyderabad, Pakistan.Methodology:Subjects and methods for observational study were undertaken at the Department of Ophthalmology Sindh Institute Of Ophthalmology And Visual Sciences, Hyderabad, Pakistan. Hundred confirmed cases of type 1 diabetes were included in the study by non probability convenience sampling. Tear film breakup time and schrimer test were carried out to determine dry eye disease. Data was collected by self-prepared questionnaire and entered and analyzed by using Statistical Program for Social Sciences (SPSS, version 20.0). The frequencies and percentage were recorded and any associations with predisposing factors were statistically analyzed by t test.Results:Out of hundred patients, 71 (71%) were found to have dry eyes (P<0.001). The mean age of the subject in this study was 50.97 years (range 30-70 years). Old age was related to high risk of dry eye disease (P<0.001). There was no big difference in the incidence of dry eyes in males and females. Long duration was found to be related with increased occurrence of dry eyes (P<0.001). We found higher values for abnormal tear film break up time than schirmer test values leading to increased occurrence of evaporative dry eyes.Conclusion:There is marked increase in frequency/ risk of developing dry eye disease in type 1 diabetes patients. Therefore, it is recommended to have periodic ophthalmic examination for type 1 diabetic patients.

Are Serum Vitamin D Levels Associated With Dry Eye Disease? Results From the Study Group for Environmental Eye Disease.

ObjectivesDry eye disease (DED) is an increasingly important public health problem in Korea. Previous studies conducted in Korea have reported inconsistent results regarding the protective effects of vitamin D on DED, and these discrepancies may be related to the relatively simple questionnaire that has been used. Thus, we evaluated the association of serum vitamin D levels with DED using the ocular surface disease index (OSDI).MethodsThe present study evaluated data from participants in the Study Group for Environmental Eye Disease (2014-2015). This group included data from 752 participants, and data from 740 participants (253 men and 487 women) were analyzed in the present study. DED severity was evaluated using the OSDI.ResultsHigher serum vitamin D levels were associated with a non-significantly reduced risk of DED in the crude analysis (odds ratio [OR], 0.991; 95% confidence interval [CI], 0.971 to 1.011) and in the adjusted analysis (OR, 0.988; 95% CI, 0.966 to 1.010). In the crude analysis of no/mild DED vs. moderate/severe DED, men exhibited a decreased risk with increasing serum vitamin D levels (OR, 0.999; 95% CI, 0.950 to 1.051), while women exhibited an increased risk (OR, 1.003; 95% CI, 0.979 to 1.027). In these analyses, we found no significant associations.ConclusionsThe findings of the present study support previous reports that serum vitamin D levels are not associated with DED.

Tear Film Steroid Profiling in Dry Eye Disease by Liquid Chromatography Tandem Mass Spectrometry.

Dry eye disease (DED) is a multifactorial disorder of the ocular surface unit resulting in eye discomfort, visual disturbance, and ocular surface damage; the risk of DED increases with age in both sexes, while its incidence is higher among females caused by an overall hormonal imbalance. The role of androgens has recently investigated and these hormones were considered to have a protective function on the ocular surface. In order to correlate DED to tear steroid levels, a robust, specific, and selective method for the simultaneous quantification of cortisol (CORT), corticosterone (CCONE), 11-deoxycortisol (11-DECOL), 4-androstene-3,17-dione (ADIONE), testosterone (TESTO), 17α-hydroxyprogesterone (17-OHP), and progesterone (PROG) was developed and applied for the analysis of tear samples. The method involves a simple extraction procedure of steroids from tears collected on Schirmer strips, followed by a high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) analysis. In total, tear samples from 14 DED female patients and 13 healthy female controls were analysed and, CORT, ADIONE, and 17-OHP response levels resulted significantly decreased in dry eye patients respect to controls. The receiver operating characteristic (ROC) curve obtained by the combination of these three steroids (AUC = 0.964) demonstrated the good diagnostic power of the differential tear steroids in identifying DED. In conclusion, the present method made it possible, for the first time, to study steroid profiling directly in tear fluid.

Smartphone use is a risk factor for pediatric dry eye disease according to region and age: a case control study.

BackgroundIn 2014, the overall rate of smartphone use in Korea was 83 and 89.8 % in children and adolescents. The rate of smartphone use differs according to region (urban vs. rural) and age (younger grade vs. older grade). We investigated risk and protective factors associated with pediatric dry eye disease (DED) in relation to smartphone use rate according to region and age.MethodsWe enrolled 916 children and performed an ocular exam that included slit lamp exam and tear break-up time. A questionnaire administered to children and their families consisted of video display terminal (VDT) use, outdoor activity, learning, and modified ocular surface disease index (OSDI) score. DED was defined based on the International Dry Eye Workshop guidelines (Objective signs: punctate epithelial erosion or short tear break-up time; subjective symptoms: modified OSDI score) We performed statistical analysis of risk factors and protective factors in children divided into groups as follows: DED vs. control, urban vs. rural, younger grade (1st to 3rd) vs. older grade (4th to 6th).ResultsA total of 6.6 % of children were included in the DED group, and 8.3 % of children in the urban group were diagnosed with DED compared to 2.8 % in the rural group (P = 0.03). The rate of smartphone use was 61.3 % in the urban group and 51.0 % in the rural group (P = 0.04). In total, 9.1 % of children in the older-grade group were diagnosed with DED compared to 4 % in the younger-grade group (P = 0.03). The rate of smartphone use was 65.1 % in older-grade children and 50.9 % in younger-grade children (P < 0.001). The mean daily duration of smartphone use was longer in the DED group than controls (logistic regression analysis, P < 0.001, OR = 13.07), and the mean daily duration of outdoor activities was shorter in the DED group than controls (logistic regression analysis, P < 0.01, OR = 0.33). After cessation of smartphone use for 4 weeks in the DED group, both subjective symptoms and objective signs had improved.ConclusionsSmartphone use in children was strongly associated with pediatric DED; however, outdoor activity appeared to be protective against pediatric DED. Older-grade students in urban environments had DED risk factors (long duration of smartphone use), and a short duration of outdoor activity time. Therefore, close observation and caution are needed when older children in urban areas use smartphones.Electronic supplementary materialThe online version of this article (doi:10.1186/s12886-016-0364-4) contains supplementary material, which is available to authorized users.

Association Between Menstrual Irregularity and Dry Eye Disease: A Population-Based Study.

To determine whether dry eye disease (DED) is associated with irregular menstruation among Korean women. In this population-based study, we randomly selected 6502 women (19-50 year olds) from nationally representative participants in the fifth annual Korea National Health and Nutrition Examination Survey (2010-2012). Data were analyzed using logistic regression to evaluate the association between menstrual irregularity and DED, while controlling for demographic characteristics, lifestyle factors, and parity. After adjusting for the women's demographic characteristics, age and body mass index, lifestyle factors (smoking, alcohol consumption, physical activity, and residential area), and parity, we found that menstrual irregularity was associated with an increased risk of DED (odds ratio, 1.49; 95% confidence interval, 1.02-2.17) and DED symptoms (odds ratio, 1.43; 95% confidence interval, 1.09-1.89). We found a significant association between DED and menstrual irregularity.

Association Between Video Display Terminal Use and Dry Eye Disease in School Children

To evaluate the risk factors of dry eye disease in school children associated with video display terminal use. Two-hundred eighty-eight children were classified in either a dry eye disease group or control group according to the diagnostic criteria of dry eye disease. The results of ocular examinations, including best-corrected visual acuity, slit-lamp examination, and tear break-up time, were compared between groups. The results of questionnaires concerning video display terminal use and ocular symptoms were also compared. Twenty-eight children were included in the dry eye disease group and 260 children were included in the control group. Gender and best-corrected visual acuity were not significantly different between the two groups. Smartphone use was more common in the dry eye disease group (71%) than the control group (50%) (P = .036). The daily duration of smartphone use and total daily duration of video display terminal use were associated with increased risk of dry eye disease (P = .027 and .001, respectively), but the daily duration of computer and television use did not increase the risk of dry eye disease (P = .677 and .052, respectively). The results showed that smartphone use is an important dry eye disease risk factor in children. Close observation and caution regarding video display terminal use, especially smartphones, are needed for children.

Prevalence of Dry Eye Disease and its Risk Factors in Visual Display Terminal Users: The Osaka Study

To investigate tear function and prevalence of dry eye disease (DED) in visual display terminal (VDT) users. Cross-sectional study. Six hundred and seventy-two young and middle-aged Japanese office workers who used VDT completed questionnaires and underwent dry eye testing. We estimated the prevalence of DED using logistic regression analysis to examine associations between DED and possible risk factors. The ocular surface feature, prevalence of DED, and risk factors were evaluated. Of the 672 workers, 561 (83.5%, mean age: 43.3 ± 9.1 years) completed the questionnaire. The percentage of women with a composite outcome of definite DED or probable DED was 76.5%, which was higher than that among men (60.2%; odds ratio [OR] = 2.00; 95% confidence interval [CI], 1.29-3.10, P = .002). Workers over 30 years of age had a higher risk of DED (OR = 2.22; 95% CI, 1.06-4.66), as did workers using a VDT >8 hours per day (OR = 1.94; 95% CI, 1.22-3.09). Average Schirmer value was 18.7 ± 11.7 mm and tear break-up time (TBUT) was 4.0 ± 2.5 seconds (78.6% of study participants had TBUT ≤5 seconds). DED is prevalent among young to middle-aged Japanese VDT users. Ophthalmic findings revealed short TBUT and corneal staining accompanied by normal Schirmer test values. Increased risk for DED was noted for women aged over 30 years and prolonged VDT use. Measures to modify the adverse impact of VDT use on the ocular surface may provide a positive impact on public health and quality of life for office workers using VDTs.

Dry eye disease in French elderly subjects: the Alienor Study

To describe dry eye disease in French elderly subjects. The Alienor Study is a population-based study on age-related eye disease in 963 residents of Bordeaux (France), aged 73 years or more. Self-reported dry eye disease and use of artificial tears were documented through face-to-face interview. Dry eye symptoms were assessed using the Ocular Surface Disease Index (OSDI) questionnaire and tear film stability by tear break-up time measurements (TBUT). Definite dry eye disease was defined as self-reported dry eye, confirmed by use of artificial tears and/or OSDI greater or equal to 22. Nine hundred and fifteen subjects, with mean age of 80 ± 4 years, returned the OSDI questionnaire. Of these, 271 (29.6%) subjects reported a dry eye disease and 135 (14.7%) were using artificial tears. An OSDI score > 22 was found in 359 (39.2%) subjects and a TBUT < 5 seconds in 335/746 (44.9%) subjects. Overall, definite dry eye affected 21.9% of subjects and was more frequent in women (27.1%) than in men (13.6%). After multivariate adjustment, dry eye disease was also significantly less frequent in subjects with high educational level (odds ratio (OR) = 0.49, 95% confidence interval (CI): 0.31-0.78 for long secondary school) and more frequent in subjects with ocular hypertension (OR = 1.61, 95% CI: 1.02-2.57) and those using anxiolytics (OR = 1.53, 95% CI: 1.02-2.29). This large observational study confirmed the high prevalence of dry eye symptoms among elderly subjects and confirmed some of the previously identified risk factors (in particular female gender and use of anxiolytics).

Efficacy of a novel moist cool air device in office workers with dry eye disease

To evaluate the efficacy and safety of new moist cool air device (MCAD) for ocular symptoms, tear film stability and ocular surface status in office workers with dry eye disease (DED). In this prospective single-centre clinical trial, 40 eyes of 20 patients with DED were recruited and randomly divided into two groups (group with MCAD exposure and group without MCAD). All subjects are visual display terminals (VDTs) workers spending at least 4 h/day in front of VDTs. Patients using MCAD underwent moist air applications for 4 h/day for a total of five working weekdays during VDT works at their offices. The other group of patients performed their VDT work without moist cool air device exposure. The change in symptoms of ocular surface (OS) dryness, fatigue and discomfort was evaluated using visual analogue scale (VAS) scores. Changes in visual function, tear functions and ocular surface status were evaluated using best-corrected visual acuity (BCVA), the functional visual acuity (FVA) test, blink rate, BUT measurements, strip meniscometry (SM), tear evaporation rate, fluorescein staining and rose bengal staining scores. Tear film lipid layer interferometry was also performed to assess the status of the lipid layer over the tear film. In addition, adverse events were recorded. In group with MCAD, symptoms of OS dryness during VDTs work, and FVA and BUT were significantly improved. SM and tear evaporation rate were significantly improved. There were no statistically significant differences on lipid layer stability and corneal staining scores in both groups. Blink rate was significantly increased in group without MCAD. No adverse events were reported during this trial. Moist cool air device use provided symptomatic relief of ocular dryness and improvement on tear stability in office workers with DED. This new device seems to be a safe and promising alternative in the treatment of DED.

Association between Depression and Dry Eye Disease in an Elderly Population

A population-based cross-sectional study to investigate the association between depression and dry eye disease (DED) in a community-dwelling elderly population. The subjects were 657 Korean elders ≥ 65 years of age randomly selected from an official household registration database in Yongin, Korea. DED symptoms were assessed using the six-item Dry Eye Questionnaire. DED signs were evaluated using the Schirmer test, fluorescein stain score, tear film break-up time (BUT). Depression was assessed using the Korean version of the Short Geriatric Depression Scale (SGDS-K). The association between DED and depression was evaluated using logistic linear analyses. The SGDS-K score correlated with the number of positive responses in the Dry Eye Questionnaire (r = 0.229, P < 0.001), but not with tear film break-up time (r = 0.041, P = 0.139) or Schirmer test score (r = 0.048, P = 0.642). In the binary logistic regression model, female sex (P = 0.014), residence in urban areas (P < 0.001), depression (P < 0.001), and Schirmer score of ≤ 5 mm (P = 0.035) were associated with the risk of DED. Depression was associated with the risk of DED (P < 0.001) in the patients with Schirmer score > 5 mm but not in those with Schirmer score ≤ 5 mm (P = 0.290). Depression was associated with DED symptoms in subjects with normal or mildly reduced tear production.

Prevalence of Dry Eye Disease Among US Men

To estimate the prevalence and risk factors for dry eye disease (DED) among US men. Cross-sectional prevalence survey among male participants 50 years and older in the Physicians' Health Studies I (N = 18,596) and II (N = 6848). We defined DED as the presence of clinically diagnosed dry eye or severe symptoms (both dryness and irritation constantly or often). We calculated the age-standardized prevalence of DED adjusted to the age distribution of US men in 2004 and projected estimates forward to 2030. We compared DED prevalence with a similar cohort of women and examined associations with possible risk factors. The prevalence of DED increased with age, from 3.90% among men aged 50 to 54 years to 7.67% among men 80 years and older (P for trend <.001). High blood pressure (odds ratio, 1.28; 95% confidence interval, 1.12-1.45) and benign prostatic hyperplasia (odds ratio, 1.26; 95% confidence interval, 1.09-1.44) were associated with a higher risk of DED. Use of antidepressants, antihypertensives, and medications to treat benign prostatic hyperplasia were also associated with increased risk of DED. The age-standardized prevalence of DED was 4.34%, or 1.68 million men 50 years and older, and is expected to affect more than 2.79 million US men by 2030. Dry eye disease is prevalent and increases with age, hypertension, benign prostatic hyperplasia, and antidepressant use.

Prevalence of Dry Eye Disease among Japanese Visual Display Terminal Users

To determine the prevalence of dry eye disease (DED) and risk factors among young and middle-aged Japanese office workers using visual display terminals (VDTs). Cross-sectional prevalence survey. Four thousand three hundred ninety-three Japanese young and middle-aged office workers using VDTs. Office workers completed questionnaires sent by e-mail designed to detect dry eye diagnosis and risk factors. Clinically diagnosed DED was defined as the presence of a previous clinical diagnosis of DED by dry eye specialists or severe symptoms of DED (both dryness and irritation constantly or often). Current symptoms of DED and possible risk factors such as age, duration of VDT use, type of VDT work, environmental factors, presence of systemic diseases, systemic medicine use, smoking history, and contact lens (CL) use were the main outcome measures. We used logistic regression to examine associations between DED and other demographic factors. Of the 4393 office workers, 3549 (80.1%) completed the questionnaire. Clinically diagnosed DED was present in 266 (10.1%) of 2640 male subjects and in 195 (21.5%) of 909 female subjects. Severe symptoms of DED were observed in 711 male and in 436 female participants. More than 4 hours of VDT use was associated with an increased risk of DED (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.40-2.02). In addition, CL use (OR, 3.91; 95% CI, 3.37-4.53) increased the risk of severe dry eye symptoms. Dry eye disease leading to a clinical diagnosis or severe symptoms is prevalent among young and middle-aged Japanese office workers. The condition is more prevalent among females, CL wearers, and prolonged VDT users. Relevant measures directed against the modifiable risks could provide a positive impact on public health and quality of life of office workers. The authors have no proprietary or commercial interest in any materials discussed in this article.

Neurobehavioral effects of power-frequency electromagnetic fields: N. Paneth, Environmental Health Perspectives Supplements, 101 (Suppl. 4)

To determine the prevalence of dry eye disease (DED) and risk factors among young and middle-aged Japanese office workers using visual display terminals (VDTs).Cross-sectional prevalence survey.Four thousand three hundred ninety-three Japanese young and middle-aged office workers using VDTs.Office workers completed questionnaires sent by e-mail designed to detect dry eye diagnosis and risk factors.Clinically diagnosed DED was defined as the presence of a previous clinical diagnosis of DED by dry eye specialists or severe symptoms of DED (both dryness and irritation constantly or often). Current symptoms of DED and possible risk factors such as age, duration of VDT use, type of VDT work, environmental factors, presence of systemic diseases, systemic medicine use, smoking history, and contact lens (CL) use were the main outcome measures. We used logistic regression to examine associations between DED and other demographic factors.Of the 4393 office workers, 3549 (80.1%) completed the questionnaire. Clinically diagnosed DED was present in 266 (10.1%) of 2640 male subjects and in 195 (21.5%) of 909 female subjects. Severe symptoms of DED were observed in 711 male and in 436 female participants. More than 4 hours of VDT use was associated with an increased risk of DED (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.40–2.02). In addition, CL use (OR, 3.91; 95% CI, 3.37–4.53) increased the risk of severe dry eye symptoms.Dry eye disease leading to a clinical diagnosis or severe symptoms is prevalent among young and middle-aged Japanese office workers. The condition is more prevalent among females, CL wearers, and prolonged VDT users. Relevant measures directed against the modifiable risks could provide a positive impact on public health and quality of life of office workers.The authors have no proprietary or commercial interest in any materials discussed in this article.