Purpose

To investigate the relationship between dry eye disease (DED) and vision-related quality of life (VR-QoL) at population level.

Methods

DED and VR-QoL were assessed in 89,022 participants (18–96 years, 59% female) from the Dutch population-based Lifelines cohort using the Women's Health study (WHS) and Visual function 25 (VFQ25) questionnaires. The relationship between DED and compromised VR-QoL was assessed with logistic regression, corrected for age, sex, BMI, income, education, smoking, and 55 comorbidities.

Results

9.1% of participants had DED. The participants with DED had higher risk of compromised average of ten domains of VR-QoL (OR 3.12 (95% CI 2.98–3.27) corrected for age, sex, BMI, income, smoking, and 55 comorbidities). Increasing symptom frequency was highly associated with decreasing VR-QoL (P < 0.0005). In all VR-QoL domains, including measures of daily visual function and emotional well-being, DED was clearly associated with compromised VR-QoL. Compared to macular degeneration, glaucoma, retinal detachment, and allergic conjunctivitis, DED presented similar or higher risks for compromised score on all VR-QoL domains. The population-attributable fraction of DED for compromised general vision exceeded that of other eye diseases investigated, especially in the younger age groups.

Conclusion

DED is associated with reductions in all domains of VR-QoL, also after correction for associated comorbidities. We found that DED imposes an extensive population burden regarding compromised VR-QoL due to its high prevalence and substantial impact on VR-QoL, higher than that for other common vision-affecting eye disorders. Our results emphasize the importance of recognizing DED as a serious disorder from both patient and public health perspectives.

中文翻译：

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干眼症的视力相关负担

目的

在人群水平上调查干眼病 (DED) 与视力相关生活质量 (VR-QoL) 之间的关系。

方法

使用女性健康研究 (WHS) 和视觉功能 25 (VFQ25) 问卷对来自荷兰人口生命线队列的 89,022 名参与者（18-96 岁，59% 女性）进行了 DED 和 VR-QoL 评估。使用逻辑回归评估 DED 与受损 VR-QoL 之间的关系，校正年龄、性别、BMI、收入、教育、吸烟和 55 种合并症。

结果

9.1% 的参与者患有 DED。患有 DED 的参与者在 VR-QoL 的 10 个领域平均受​​损的风险更高（校正年龄、性别、BMI、收入、吸烟和 55 种合并症的风险为 3.12（95% CI 2.98-3.27））。症状频率增加与 VR-QoL 降低高度相关（P < 0.0005）。在所有 VR-QoL 领域，包括日常视觉功能和情绪健康的测量，DED 明显与受损的 VR-QoL 相关。与黄斑变性、青光眼、视网膜脱离和过敏性结膜炎相比，DED 在所有 VR-QoL 领域的评分受损风险相似或更高。因一般视力受损而导致的 DED 的人群归因比例超过了所调查的其他眼部疾病，尤其是在较年轻的年龄组中。

结论

DED 与 VR-QoL 所有领域的降低有关，在校正相关合并症之后也是如此。我们发现，由于 DED 的高流行率和对 VR-QoL 的重大影响，DED 对受损的 VR-QoL 造成了广泛的人口负担，高于其他常见的影响视力的眼部疾病。我们的结果强调了从患者和公共卫生的角度认识到 DED 是一种严重疾病的重要性。