While the different forms of dry eye disease (DED) continue to be investigated, younger patients with the aqueous-deficient variety may be at a higher risk of corneal surface damage, in addition to individuals who are female and those who suffer from diabetes or autoimmune diseases, a recent paper published online in the American Journal of Ophthalmology reports.
Specifically, aqueous-deficient DED increased the risk of recurrent corneal erosion, corneal ulcers, and corneal scars in a sample of Taiwanese participants.
The study evaluated DED patient claims data, including diagnoses, drug codes and clinical follow-up, from the Taiwan National Health Insurance Research Database from 1997 to 2013. The investigation also included a healthy cohort of individuals without dry eye.
As expected, patients with dry eye had a significantly higher rate of corneal surface damage (hazard ratio; HR: 2.70), but this was especially true in DED participants under the age of 18 (HR: 6.66) compared with older patients, and in women (HR: 2.98) vs. men (HR: 2.22) compared with healthy patients.
Additionally, DED subjects who also had diabetes, rheumatic arthritis or systemic lupus erythematosus were likely to have corneal surface damage.
The overall prevalence of DED was approximately 8%, and it was higher in women (roughly 11%) than men (about 5%). The condition also increased with age:
- under 18: 0.53%
- 18 to 39: 4%
- 40 to 64: 10%
- over 65: 21%
Although aging has been identified as a risk factor for DED, the current analysis showed that patients younger than 18 years had the highest risk of corneal surface damage in DED, which the authors attributed to differences in health-seeking behavior, increased use of digital devices, use of soft contact lenses, and eye rubbing.
These findings suggest that patients with DED who have these risk factors warrant early clinical evaluation for timely intervention, researchers said.
Hung N, Kang EYC, Lee TW, et al. The risks of corneal surface damage in aqueous deficient dry eye disease: a 17-year population-based study in Taiwan. Am J Ophthalmol. March 24, 2021. [Epub ahead of print].