A cross-sectional study of non-modifiable and modifiable risk factors of dry eye disease states

Abstract

Purpose: The present study aimed to determine the relationship of non-modifiable (rheumatoid arthritis, thyroid diseases, and arterial hypertension) and modifiable risk factors (diuretics, antidepressants, or anxiolytics tranquilizers) with the different Dry Eye Disease (DED) diagnostics in a sample adjusted by antihistamines intake.

Methods: A total of 400 participants were included in a cross-sectional study. Before a dry eye examination, participants completed an online self-administered OSDI questionnaire with six additional questions about possible DED risk factors. The Tear Film and Ocular Surface Society Dry Eye Workshop II (TFOS DEWS-II) diagnostic criteria of DED was used. Based on signs and/or symptoms, participants were divided into 4 groups: No DED, Pre-clinical DED, Predisposition to DED and DED. Since the symptom scores would have been altered by the use of antihistamines, the analysis of each outcome was adjusted for this factor, where those participants were assumed to be symptomatic.

Results: Multivariable logistic regression found thyroid disease as a possible risk factor for DED (OR 4.53, 95 % CI 1.04-19.73; Fisher's exact, p = 0.044; Crameŕs V = 0.140, p = 0.024). No association was found between the studied parameters and Pre-clinical DED (Fisher's exact, all p ≥ 0.398; Crameŕs V, all p ≥ 0.242) or Predisposition to DED (Fisher's exact, all p ≥ 0.065; Crameŕs V, all p ≥ 0.031).

Conclusion: Participants with thyroid disease were more likely to develop DED, therefore, thyroid disease could be a risk factor for DED.

Keywords: Arterial hypertension; Dry eye; Odds ratio; Risk factor; Thyroid disease; Tranquilizers.