Prevalence and determinants of dry eye disease among 40 years and older population of Riyadh (Except Capital), Saudi Arabia

Abstract

PURPOSE: The prevalence and determinants of dry eye disease (DED) among 40 years and older population of Riyadh (except capital), Saudi Arabia. SUBJECTS AND METHODS: A population-based survey was conducted in Riyadh district between 2013 and 2017. All Saudi aged >40 years attended at the Primary Health Center were the study population. McCarty Symptom Questionnaire was adopted. A representative sample was examined. The best-corrected visual acuity and anterior and posterior segment assessment were performed. DED was graded as absent, mild, moderate, and severe. RESULTS: We examined 890 participants. The age- and sex-adjusted prevalence of DED was 45.1% (95% confidence interval [CI] = 44.8–45.4). One-third of the participants had DED. However, two-third of DED cases were of mild grade. The prevalence of DED among females was significantly higher. The variation of DED by age group was not statistically significant (χ 2 = 2.6, Degree of freedom = 3, and P = 0.1). Presence of glaucoma was significantly associated to DED (odds ratio [OR] = 2.6, [95% CI = 1.2–5.6], and P = 0.01). Use of topical glaucoma medication was significantly associated to DED (OR = 4.6 [95% CI = 1.8–11.8], and P = 0.001). However, severity of DED was not found to be associated with glaucoma medication (χ 2 = 2.6, P = 0.1). Associations of diabetes and hypertension to DED were not statistically significant (OR = 0.97 [95% CI = 0.73–1.3], and P = 0.84) (OR = 1.1 [95% CI = 0.8–1.4], and P = 0.6). The severe visual impairment was not associated to the grade of DED ( P = 0.55). CONCLUSION: The prevalence of DED among Saudi is high, but severe DED is found to be less. Association with female gender, glaucoma, and topical glaucoma medications was reported. Association with diabetes, hypertension, and age group variation was not significant.

A systematic review on prevalence, risk factors, clinical diagnosis and medical management of dry eye disease in the Arab population

“…The latest development is a prevalence study of DE in Riyadh district based on a prospective study by utilising the McMonnies' DE questionnaire. 12 A similar study reported that the overall prevalence of DE was 35.9% in cases ≥ 40 years of age (Table 1). Another study, which observed the frequency of DE in the Northern Region of Saudi Arabia, was performed by Alsweilem et al 19 Their sample consisted of 384 teenagers, which was investigated at 3 months for data collection.…”

“…This may be because of the high percentage of rheumatoid arthritis, DM and the use of age-related systemic and topical medications, which may lead to deterioration of TF intact. 5,12 Furthermore, gender is another factor that has been documented to influence TF profile. 6,7 Arab data found altered rate of tear production in women as compared to men, particularly after…”

“…Increase in age Alzahrani et al 21 ; Alshamrani et al 23 ; Alharbi et al 27 ; Shanti et al 31 ; Sherry et al 35 Female gender Yasir et al 12 ; Alshamrani et al 23 ; Shanti et al 31 ; Haddad et al 36 ; Shadia et al 58 CLs uses Alsweilem et al 20 ; Sharief 37 Refractive operations and cataract operation Alsweilem et al 20 ; Alzahrani et al 23 ; Sharief 37; Kalakattawi et al 59 Glaucoma, medications, topical glaucoma eye drops and biological drugs Yasir et al 12 ; Younis and Al-Quzweeni 32 Using antidepressants drug and/or multivitamins supplements Alharbi et al 27 Acanthamoeba keratitis, pterygium, blepharitis, spring catarrh, MGD, allergic conjunctivitis and keratoconus Omran et al 17 ;Alsweilem et al 20 ;Zbiba et al 34 ; Sharief 37 ; Awad et al 60 ; El Sawy et al 61 Rheumatoid arthritis, thyroid diseases and high total cholesterol levels Alzahrani et al 21 ; Alharbi et al 27 ; Younis 32 ; Abusharaha et al 62 ; ALANAZI 63 Diabetes mellitus Alshamrani et al 23 ; Alzahrani et al 21 ; Alharbi et al 27 ; Masmali et al 64 ; Kamel et al 65 ; El Sawy et al 61 ; Kalakattawi et al 59 ; Elnour et al 66 ; Masmali et al 64 Hypertension, dyslipidaemia and obesity Safaa Bashir et al 67 ; Alghamdi 68 Wider us...…”

“…21,23 On the same note, according to previous surveys, many ocular diseases such as blepharitis, glaucoma, MGD, keratoconus, spring catarrh, pterygium and allergic conjunctivitis have been identified as the risk factors of DED in the Arab population. 12,16,17,37 2.…”

<p>Outcomes of Combined iStent Trabecular Micro-Bypass and Cataract Surgery for the Treatment of Open-Angle Glaucoma in a Saudi Population</p>

“…A lower medication burden may facilitate a more optimal adherence to medication. 6,[24][25][26] Moreover, dry eye is highly prevalent amongst the Saudi population 27,28 and the use of antiglaucoma medication can cause further damage to the ocular surface. A reduction of topical anti-glaucoma medications after ab interno trabecular bypass surgery may improve the ocular surface.…”