Purpose

To investigate the impact of ageing on ocular surface parameters, and empirically determine optimal prognostic cut-off ages for clinical markers of dry eye disease, aqueous tear deficiency, and meibomian gland dysfunction.

Methods

A total of 1331 community residents (785 females, 546 males; mean ± SD age, 38 ± 19 years) were recruited in a prospective registry-based cross-sectional study. Dry eye symptomology, ocular surface characteristics, and tear film quality were evaluated for each participant within a single clinical session, in accordance with the global consensus recommendations of the TFOS DEWS II reports.

Results

Multivariate regression analysis demonstrated positive associations between ageing and clinical markers of dry eye disease (all p ≤ 0.001). The Youden-optimal prognostic cut-off ages for signs of meibomian gland dysfunction occurred during the third decade of life (24–29 years); the optimal predictive ages for lid wiper epitheliopathy, tear film instability, hyperosmolarity, and dry eye symptoms occurred during the fourth decade of life (31–38 years); while the optimal prognostic thresholds for signs of aqueous tear deficiency and ocular surface staining occurred in the fifth and sixth decades of life (46–52 years).

Conclusions

Advancing age is a significant risk factor for dry eye disease, which represents a growing public health concern with the ageing population worldwide. Signs of meibomian gland dysfunction appeared earlier in the natural history of disease progression, and the brief delay prior to the development of other clinical dry eye signs might represent a window of opportunity for preventative interventions in the young adult age group.

中文翻译：

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衰老和干眼病的自然史：一项基于前瞻性注册表的横断面研究。

目的

研究衰老对眼表参数的影响，并根据经验确定干眼病，房水性泪液缺乏和睑板腺功能障碍的临床标志的最佳预后年龄。

方法

在一项基于注册表的前瞻性横断面研究中，共招募了1331名社区居民（785名女性，546名男性；平均年龄±SD，38±19岁）。根据TFOS DEWS II报告的全球共识建议，在单个临床会议中评估了每个参与者的干眼症状，眼表特征和泪膜质量。

结果

多元回归分析表明，衰老与干眼病的临床指标之间存在正相关（所有p≤0.001）。睑板腺功能障碍迹象的尤登最优预后年龄发生在生命的第三个十年（24-29岁）。盖玻片上皮病，泪膜不稳定，高渗性和干眼症状的最佳预测年龄发生在生命的第四个十年（31-38岁）；而水性泪液缺乏和眼表染色迹象的最佳预后阈值发生在生命的第五和第六个十年（46-52岁）。

结论

年龄增长是干眼病的重要危险因素，这代表着全球人口老龄化对公共卫生的关注与日俱增。睑板腺功能障碍的征兆出现在疾病进展的自然史中较早，在其他临床干眼征兆出现之前的短暂延迟可能代表了在年轻成年年龄组进行预防性干预的机会之窗。