Sex and age differences in symptoms and signs of dry eye disease in a Norwegian cohort of patients,The Ocular Surface

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Sex and age differences in symptoms and signs of dry eye disease in a Norwegian cohort of patients
The Ocular Surface ( IF 5.9 ) Pub Date : 2020-11-24 , DOI: 10.1016/j.jtos.2020.11.009
Sara Tellefsen Nøland ₁ , Reza A Badian ₂ , Tor P Utheim ₃ , Øygunn A Utheim ₄ , Aleksandar Stojanovic ₅ , Behzod Tashbayev ₆ , Sten Raeder ₇ , Darlene A Dartt ₈ , Xiangjun Chen ₉

Affiliation

Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; National Centre for Vision, Optics and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway.
Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; National Centre for Vision, Optics and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway; Department of Ophthalmology, Vestre Viken Hospital Trust, Drammen, Norway; Department of Ophthalmology, Oslo University Hospital, Oslo, Norway; Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway; Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway; Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway.
Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, Oslo University Hospital, Oslo, Norway; The Norwegian Dry Eye Clinic, Oslo, Norway.
Department of Ophthalmology, University Hospital of North Norway, Tromsø, Norway.
Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway.
The Norwegian Dry Eye Clinic, Oslo, Norway.
Schepens Eye Research Institute/Massachusetts Eye and Ear/Department of Ophthalmology, Harvard Medical School, Boston, MA, United States.
National Centre for Vision, Optics and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway; Department of Ophthalmology, Vestre Viken Hospital Trust, Drammen, Norway; Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway; The Norwegian Dry Eye Clinic, Oslo, Norway; Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway.

Purpose

To investigate sex and age differences in symptoms and signs in a Norwegian clinic-based cohort of patients with dry eye disease (DED).

Methods

Visitors at the Norwegian Dry Eye Clinic were examined using Ocular Surface Disease Index (OSDI) questionnaire score, tear osmolarity, tear break-up time (TFBUT), ocular surface staining, corneal sensitivity, Schirmer I test, and meibum expressibility (ME) and quality (MQ). A diagnosis of DED was made by an ophthalmologist based on symptoms and signs, and only DED patients were enrolled in the study: 1823 patients (338 males; mean age 51.2 ± 16.2 years; 1485 females; mean age 52.5 ± 16.0 years). The patients were divided into age subgroups: 20–39 years, 40–59 years and ≥60 years. Sex differences in the aforementioned tests were analyzed. Values were reported as mean ± standard deviation (SD), and intergroup comparisons were performed using Mann-Whitney U test. Multiple regression was used to analyze sex and age influences on symptoms and signs.

Results

When patients of all ages were analyzed, females had increased osmolarity, shorter TFBUT, reduced MQ and ME and higher corneal sensitivity. OSDI, Schirmer I test, ocular surface staining and corneal staining were not significantly different between the sexes. Only with TFBUT and ME were the sex difference present in all age subgroups. Multiple regression showed that all parameters were influenced by either sex or age, but only TFBUT and ME were influenced by both sex and age. (all p < 0.05).

Conclusions

Sex and age differences in dry eye were most consistent in TFBUT and ME, that indicate differences in meibomian gland functionality. Sex and age subgroup stratification is important in future studies investigating DED in other populations.

中文翻译：

挪威患者队列中干眼病症状和体征的性别和年龄差异

目的

调查基于挪威临床的干眼病 (DED) 患者队列中症状和体征的性别和年龄差异。

方法

挪威干眼症诊所的访客接受了眼表疾病指数 (OSDI) 问卷评分、泪液渗透压、泪液破裂时间 (TFBUT)、眼表染色、角膜敏感性、Schirmer I 测试和睑脂可表达性 (ME) 和质量 (MQ)。DED 的诊断由眼科医生根据症状和体征做出，仅 DED 患者参加了研究：1823 名患者（338 名男性；平均年龄 51.2 ± 16.2 岁；1485 名女性；平均年龄 52.5 ± 16.0 岁）。将患者分为年龄亚组：20-39岁、40-59岁和≥60岁。分析了上述测试中的性别差异。值报告为平均值 ± 标准差 (SD)，并使用 Mann-Whitney U进行组间比较测试。多元回归用于分析性别和年龄对症状和体征的影响。

结果

当对所有年龄段的患者进行分析时，女性的渗透压增加，TFBUT 缩短，MQ 和 ME 降低，角膜敏感性更高。OSDI、Schirmer I 试验、眼表染色和角膜染色在两性之间没有显着差异。只有 TFBUT 和 ME 在所有年龄亚组中都存在性别差异。多元回归显示所有参数都受性别或年龄的影响，但只有 TFBUT 和 ME 受性别和年龄的影响。（所有 p < 0.05）。