Quality of life measures and health utility values among dry eye subgroups

Abstract

BackgroundTo determine whether quality of life (QOL) and health utility are affected to the same extent among dry eye (DE) patients with short tear film break-up time dry eye (TBUT-DE) with minimal clinical signs were as severe as aqueous-deficient dry eye (ADDE).MethodsA multicenter cross-sectional study was conducted among DE patients who visited one of 10 eye clinics in Japan. Among the 463 registered patients, this study involved 449 patients with DE who were aged 20 years or older. Ophthalmic examination findings were assessed, including tear film break-up time (TBUT), Schirmer I value, and keratoconjunctival staining score. QOL was evaluated with the Dry Eye-Related Quality-of-Life Score (DEQS; 0 [best], 100 [worst]) and health utility (1 [total health], 0 [worst]) with the Health Utilities Index Mark 3 (HUI-3); scores were stratified by DE subgroup.ResultsMedian (interquartile range) of DEQS and HUI-3 scores across all participants were 21.7 (10.0–40.0) and 0.82 (0.69–0.91), respectively. Median (interquartile range) DEQS and HUI-3 scores in the ADDE group were 23.3 (10.0–40.0) and 0.79 (0.69–0.88), respectively; those in the short TBUT-DE group were 23.3 (13.3–38.3) and 0.82 (0.74–0.92), respectively. There were no significant between-group differences in questionnaire scores. Among the ophthalmic examination findings, a weak significant correlation between TBUT, corneal staining score and keratoconjunctival staining score to DEQS; TBUT and Schirmer test values to HUI-3, were seen.ConclusionsThe burden of short TBUT-DE on QOL as assessed by the DEQS and HUI-3 was as severe as that in ADDE. Our findings suggest that clinicians should be aware of the impact of short TBUT-DE on patients QOL and utility values.Trial registrationUniversity Hospital Medical Information Network (registration no. UMIN 000015890). Registered 10th December 2014, retrospectively registered.

Characteristics and Utility of Fluorescein Breakup Patterns among Dry Eyes in Clinic-Based Settings

“…We collected data from the DECS-J, which was a cross-sectional observational study conducted at 10 eye clinics in Japan [ 6 , 18 , 19 ]. All investigators at the study sites were specialists in ocular surface disorders and DED and belonged to the Japanese Dry Eye Society.…”

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“…Dry eye disease is accompanied by negative health-related quality of life consequences 47 with a significant impact on the symptoms of depression. 48 Shigeyasu and coauthors reported a significant reduction in quality-of-life in Japanese dry eye patients 31 and, vision-related quality-of-life was found to be impaired in Chinese dry eye patients as well as being also correlated with anxiety and depression. 49 While the consequences of reduced quality of life in dry eye patients can include mood alterations, depression and anxiety, 50 similarly dry eye disease is prevalent in patients with depressive and anxiety disorders, especially for patients who are older, have longer duration of psychiatric disorder, and who use a selective serotonin reuptake inhibitor.…”

“… 30 Patients with contributions to their symptoms from both neuropathic and tear dysfunction mechanisms might be the most confusing and difficult to help. There is no drug targeting neuropathic pain 31 but maintenance of optimum tear homeostasis and avoidance of harsh environments which challenge tear functions, may aid repair of any corneal nerve damage.…”