Dry Eye Assessment in Patients With Vitiligo

Erdur, Sevil Karaman; Aydin, Rukiye; Balevi, Ali; Özsütçü, Mustafa; Kocabora, Mehmet Selim

doi:10.1097/ico.0000000000001469

Cited by 10 publications

(27 citation statements)

References 15 publications

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“…The association between vitiligo and dry eye was demonstrated in certain case-control studies, and our study further confirmed this association [24-26, 28, 29, 31]. According to the Tear Film and Ocular Surface Society (TFOS) Dry Eye Workshop (DEWS) II Diagnostic criteria, the diagnosis of dry eye disease consists of dry eye-related symptoms along with one of the homeostasis markers (TBUT, osmolality, and ocular surface staining) [43].…”

Section: Discussionsupporting

confidence: 87%

“…According to the Tear Film and Ocular Surface Society (TFOS) Dry Eye Workshop (DEWS) II Diagnostic criteria, the diagnosis of dry eye disease consists of dry eye-related symptoms along with one of the homeostasis markers (TBUT, osmolality, and ocular surface staining) [43]. Four out of the six included studies evaluated ocular surface staining, but only two of them performed with the Oxford scale, which showed no significant differences among patients with vitiligo and control [29, 31]. Due to the paucity of evidence, the ocular staining test was not further analyzed in our study.…”

Section: Discussionmentioning

confidence: 99%

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Ocular Abnormalities in Patients with Vitiligo: A Systematic Review and Meta-Analysis

Chang

et al. 2022

Dermatology

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Background: Vitiligo is a skin depigmentation disorder that results from the autoimmune destruction of cutaneous melanocytes. Several ocular abnormalities, including uveitis, dry eye, glaucoma, and retinal diseases, have been reported in patients with vitiligo. The aim of our study was to investigate the association of ocular abnormalities with vitiligo. Methods: This meta-analysis was registered in PROSPERO (CRD42021224167) and adhered to MOOSE checklist and PRISMA guidance for all processes. PubMed, Embase, Web of Science, and Cochrane databases were searched for studies examining the association between ocular abnormalities and vitiligo from inception to December 10, 2020. Studies recruiting patients with Sjogren’s syndrome or Vogt-Koyanagi-Harada syndrome were excluded. The primary outcomes were the Schirmer test, tear film break-up time (TBUT), and ocular surface disease index (OSDI) of vitiligo patients compared to the controls. The risk of bias of the selected studies was assessed using the Newcastle-Ottawa Scale (NOS) of case-control studies. Results: This meta-analysis of 16 case-control studies showed that patients with vitiligo had significantly lower Schirmer test values (mean difference [MD], −1.65; 95% CI, −2.81 to −0.49), shorter TBUTs (MD, −4.66; 95% CI, −7.05 to −2.26), higher ocular surface disease indices (MD, 18.02; 95% CI, 5.7–30.35), and thinner subfoveal choroidal thicknesses (MD, −53.10; 95% CI, −69.84 to −36.36). No significant differences were found in the prevalence of glaucoma and the level of intraocular pressure. Conclusions: Our study supports an association between dry eye and thinner subfoveal choroidal thickness in patients with vitiligo. Dermatologists should be aware of these possible comorbidities and refer vitiligo patients with ocular symptoms to ophthalmologists for further management.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Ocular Abnormalities in Patients with Vitiligo: A Systematic Review and Meta-Analysis

Chang

et al. 2022

Dermatology

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“…Nevertheless, our work supports the fact that periocular skin involvement in vitiligo patients is not a predictor of eye affection, a topic that has been studied with conflicting results in the past years. [19][20][21] Our data demonstrate a significantly lower CDVA in vitiligo patients when compared to age-and sex-matched controls. We could find two studies with ophthalmic assessment of vitiligo patients that included visual acuity comparisons with controls, and in both studies, the results showed that the difference was not statistically significant.…”

Section: Discussionsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Assessment of the Effect of Vitiligo on Subfoveal Choroidal Thickness Using Spectral-Domain Optical Coherence Tomography

Fouad

Salman

Mohamed

et al. 2020

OPTH

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Background: Vitiligo is a common skin condition affecting 0.5-2% of the population. The exact etiology of the condition is unknown, but the result is autoimmune destruction of melanocytes. The eye is rich in melanocytes, especially in the retinal pigment epithelium and choroid. Little is known about the effect of vitiligo on the choroid of the eye. Methods: We cross-sectionally examined 31 right eyes of 31 vitiligo patients and 32 right eyes of 32 age-and sex-matched controls for signs of vitiligo affection and then measured the subfoveal choroidal thickness (SFCT) using spectral-domain optical coherence tomography. Results: There was a statistically significant difference between SFCT in the cases group and the control group (Mean ± SD: 251.9 ± 42.0 μm and 296.8 ± 46.4 μm, respectively, p = 0.0002). The thickness correlated negatively with age (r = −0.5) but did not correlate significantly with disease severity or duration (r = −0.201, −0.1781, p = 0.2783, 0.3381, respectively). Additional examination findings included iris and fundus hypopigmented spots, and peripapillary atrophy. Conclusion: SFCT is reduced among patients with vitiligo. The clinical implications of such a finding should be studied further, and eye screening programs should be considered.

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“…A study by Dogan et al 17 showed higher OSDI score, shorter TBUT, and shorter Schirmer test distance in vitiligo patients but the results were not statistically significant. Recently, Erdur et al 18 evaluated ocular surface and tear film parameters in vitiligo patients with and without periocular involvement and compared them with controls. They showed that patients with vitiligo had higher OSDI score, lower TBUT, and higher tear osmolality, but there was no significant difference in Schirmer test and ocular surface staining between the groups.…”

Section: Discussionmentioning

confidence: 99%

Dry Eye and Meibomian Glands in Vitiligo

Taheri¹,

Allahyari²,

Rudi³

et al. 2021

tjo

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Objectives: To evaluate aqueous and lipid tear film parameters and the meibomian glands (MGs) with non-contact meibography in patients with vitiligo. Materials and Methods: This case-control study was conducted in the right (OD) and left (OS) eyes of 43 patients with vitiligo and 43 controls in Birjand, Iran. In addition to demographic information and skin disease characteristics, the Ocular Surface Disease Index (OSDI) questionnaire was completed for each patient, followed by eye examinations including slit lamp examination, Schirmer test, strip meniscometry (SMTube), and tear break-up time (TBUT) measurement. The MGs were also imaged using a non-contact meibography system (SBM System, Italy). The data were analyzed using SPSS version 22.0 with a significant level of less than 0.05. Results: Patients had higher OSDI score than controls but it was not significant (10.90±13.03 vs. 5.57±6.85; p=0.07). There were significant differences between the groups in mean Schirmer test values for both eyes (OD: 8.07±5.47 vs. 17.37±6.52; OS: 7.60±5.00 vs. 17.30±6.44, p<0.001) and mean SMTube results (OD: 4.49±2.40 vs. 9.74±3.67; OS: 4.30±2.81 vs. 9.65±4.52; p<0.001). However, mean TBUT did not differ between the groups (OD: 9.14±3.17 vs. 10.12±2.08, p=0.27; OS: 9.16±3.30 vs. 10.05±2.10, p=0.25). Meibography also showed no significant difference in MG dropout between the groups (OD: 20.86±9.79 vs. 21.05±12.07; p=0.74; OS: 18.16±8.83 vs. 19.53±10.30; p=0.51). Conclusion: Vitiligo is associated with a reduction in the production of aqueous tear film, but does not affect the structure and function of the MGs.

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Dry Eye Assessment in Patients With Vitiligo

Abstract: This study showed that vitiligo is associated with tear hyperosmolarity and tear film dysfunction. Patients with vitiligo with periocular involvement may be more prone to dry eye than those without ocular involvement.

Cited by 10 publications

References 15 publications

Ocular Abnormalities in Patients with Vitiligo: A Systematic Review and Meta-Analysis

Ocular Abnormalities in Patients with Vitiligo: A Systematic Review and Meta-Analysis

<p>Assessment of the Effect of Vitiligo on Subfoveal Choroidal Thickness Using Spectral-Domain Optical Coherence Tomography</p>

Dry Eye and Meibomian Glands in Vitiligo

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