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. 2018 Dec 21:13:53-62.
doi: 10.2147/OPTH.S190803. eCollection 2019.

Risk factors for ocular surface damage in Mexican patients with dry eye disease: a population-based study

Alejandro Rodriguez-Garcia  1 , Denise Loya-Garcia  1 , Everardo Hernandez-Quintela  2 , Alejandro Navas  3
Affiliations

Risk factors for ocular surface damage in Mexican patients with dry eye disease: a population-based study

Alejandro Rodriguez-Garcia et al. Clin Ophthalmol. .

Abstract

Purpose: To analyze potential risk factors for ocular surface damage in a representative population of Mexican patients with dry eye disease (DED).

Patients and methods: A prospective and cross-sectional population-based epidemiologic cohort study was conducted through a survey of patients with symptoms, signs, known preexisting diagnosis, and clinical conditions related to DED. Fluorescein staining, tear break-up time (TBUT), and Oxford lissamine green staining were performed on both eyes of patients enrolled in the study.

Results: A total of 2,725 surveys including 1,543 (56.6%) women and 1,182 (43.3%) men were analyzed. Most common pre-existing diagnosis included dry eye (58%), chronic blepharitis (17%), and ocular allergy (15%). More than 70% of patients had a positive fluorescein test, and this prevalence increased proportionally to the number of reasons for consultation. The same was true for gender (P<0.001) and age (P<0.0001), with women showing a strong correlation with age (R2=0.93912, P=0.001). The association between positive fluorescein staining and diagnosis was significant for dry eye (P<0.0001), Sjögren's syndrome (P<0.0001), and glaucoma (P<0.05). No significant association between TBUT and age or gender was found, but the shorter the TBUT, the larger the prevalence of fluorescein staining. Reduced TBUT was seen more frequently in patients with dry eye (57%), ocular allergy (16%), and chronic blepharitis (15%). Most patients (39%) with Oxford grades III and IV were older, complained of red eye (51.0%), foreign body sensation (47.0%), burning (46.0%), and were using eye drops (67%) and systemic medications (47%).

Conclusion: The Mexican profile of patients with significant ocular surface damage related to DED includes women at older ages, complaining of red eye, foreign body, and burning sensation. Diagnoses of dry eye, Sjögren's syndrome, and glaucoma were also risk factors for significant ocular surface damage, along with long-term use of preserved eyes drops and systemic medications.

Keywords: Oxford scale; fluorescein staining; lacrimal dysfunction; ocular surface disease; tear break-up time.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Forest plot showing the relative risk (chi-squared test) for ocular surface damage recorded as positive corneal fluorescein staining in at least one eye according to pre-existing diagnosis and clinical conditions. Note: aKeratorefractive or cataract; bP<0.05. Abbreviation: RR, risk ratio.
Figure 2
Figure 2
Prevalence of dry eye symptoms and its correlation with a positive fluorescein test in at least one eye.
Figure 3
Figure 3
Proportion of a positive fluorescein test according to the number of reasons for consultation.
Figure 4
Figure 4
Proportions of a positive fluorescein test according to gender and its correlation with age. Notes: *Positive fluorescein test in at least one eye. †(P=0.001)
Figure 5
Figure 5
Proportions of lissamine green staining scores for each eye according to the Oxford scheme and its relation to the tear break-up time. Abbreviations: TBUT, tear break-up time; sec, seconds; OD, right eye; OS, left eye.
Figure 6
Figure 6
Profile of patients with severe ocular surface damage corresponding to grades III and IV of the Oxford lissamine green staining scheme. Note: *RA/SLE. Abbreviations: RA, rheumatoid arthritis; SLE, systemic lupus erythematosus.
Figure 7
Figure 7
Comparison of positive corneal fluorescein staining between patients previously treated with preserved and preservative-free eye drops over time.
See this image and copyright information in PMC

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