Association of Dry Eye with Laryngopharyngeal Reflux in Clinical Practice,Current Eye Research

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Association of Dry Eye with Laryngopharyngeal Reflux in Clinical Practice
Current Eye Research ( IF 1.7 ) Pub Date : 2021-09-19 , DOI: 10.1080/02713683.2021.1971721
S Bonini ₁ , M Labetoulle ₂ , E Messmer ₃ , P Aragona ₄ , J M Benitez Castillo ₅ , G Ciprandi ₆ , V Damiani ₇ , M Irkec ₈ , C Baudouin ₉ , M Rolando ₁₀

Affiliation

Ophthalmology Department, Campus Bio-Medico University, Rome, Italy.
Ophthalmology Départment, Hôpitaux Universitaires Paris-Sud, APHP, Université Paris-Saclay, IDMIT Infrastructure, CEA, Inserm U1184, Fontenay-aux-Roses Cedex, France.
Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
Department of Biomedical Sciences, Ophthalmology Clinic, University of Messina, Messina, Italy.
Departamento de Oftalmología, Hospital Clínico San Carlos, Clínica Rementeria, Instituto Investigaciones Oftalmologicas Ramon Castroviejo, Universidad Complutense, Madrid, Spain.
Allergy Clinic, Casa di Cura Villa Montallegro, Genoa, Italy.
DMG Italia Medical Department, Rome, Italy.
Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Quinze-Vingts National Eye Hospital, IHU ForeSight, Paris Saclay University, Paris, France.
Ocular Surface Centre, ISPRE Ophthalmics, Genoa, Italy.

ABSTRACT

Background

Dry eye disease (DED) is a common disorder, accounting for up to 35% of the general population. Therefore, we hypothesized that laryngopharyngeal reflux (LPR), inducing refluxate rising into airways, may involve the ocular surface and may either induce or worsen DED.

Aim

To investigate the prevalence and relevance of suspected LPR in DED patients and subjects with refractive problems (RP) without DED, they were defined as non-dry eye group (NEG) in clinical practice.

Methods

This retrospective study included consecutive patients evaluated because of dry eye-like symptoms at eight tertiary ophthalmological clinics. Parameters included reflux symptom index (RSI), ocular surface disease index (OSDI), symptom assessment in dry eye (SANDE) for frequency and severity, Schirmer test, tear break-up time (BUT), and Oxford grading.

Results

The study included 245 subjects (72.5% females; mean age 56.3 years), 152 DED patients, and 93 sex- and age-matched NEG subjects. Pathological RSI (score>13) was detected in 80 subjects (32.6%); 68 (85%) with DED and 12 (15%) CG (OR = 8; p < .0001). In NEG, pathological RSI was associated with higher SANDE (Frequency and Severity), OSDI, and Schirmer scores (OR = 16.36; 14.51; 12.54; and 7.22, respectively. In DED patients, pathological RSI was associated with higher OSDI values (OR = 8.75).

Conclusion

Patients with DED are at eight times higher risk for having pathological RSI than NEG patients. Moreover, pathological RSI was associated with more severe ocular symptoms both in DED and non-DED patients. The role of LPR in definite DED patients remains to be clarified, but this condition deserves to be investigated in managing patients with DED symptoms.

中文翻译：

临床实践中干眼症与咽喉反流的关联

摘要

背景

干眼病 (DED) 是一种常见疾病，占总人口的 35%。因此，我们假设喉咽反流（LPR），诱导反流上升到气道，可能涉及眼表，并可能诱发或恶化 DED。

目标

为了调查 DED 患者和没有 DED 的屈光问题（RP）受试者中疑似 LPR 的患病率和相关性，他们在临床实践中被定义为非干眼组（NEG）。

方法

这项回顾性研究包括在八家三级眼科诊所因干眼样症状而评估的连续患者。参数包括反流症状指数 (RSI)、眼表疾病指数 (OSDI)、干眼症症状评估 (SANDE) 的频率和严重程度、Schirmer 测试、泪液破裂时间 (BUT) 和牛津分级。

结果

该研究包括 245 名受试者（72.5% 为女性；平均年龄 56.3 岁）、152 名 DED 患者和 93 名性别和年龄匹配的 NEG 受试者。在 80 名受试者（32.6%）中检测到病理性 RSI（评分>13）；68 (85%) 与 DED 和 12 (15%) CG (OR = 8; p < .0001)。在 NEG 中，病理性 RSI 与较高的 SANDE（频率和严重性）、OSDI 和 Schirmer 评分相关（OR = 16.36；14.51；12.54；和 7.22，分别为。在 DED 患者中，病理性 RSI 与较高的 OSDI 值相关（OR = 8.75）。