TFOS Lifestyle: Impact of societal challenges on the ocular surface

Stapleton, Fiona; Abad, Juan Carlos; Barabino, Stefano; Burnett, Anthea; Iyer, Geetha; Lekhanont, Kaevalin; Li, Tianjing; Yang, Liuyan; Navas, Alejandro; Obinwanne, Chukwuemeka Junior; Qureshı, Riaz; Roshandel, Danial; Şahin, Afsun; Shi, Kendrick; Tichenor, Anna A; Jones, Lyndon

doi:10.1016/j.jtos.2023.04.006

Cited by 27 publications

(11 citation statements)

References 524 publications

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“…This study showed that alcohol use and drug misuse were strongly associated with increased LOS. Chronic consumption of alcohol has been linked to vitamin A deficiency via the induction of ethanol-inducible cytochrome P-450 in the liver, leading to morphologic changes on the ocular surface in the form of conjunctival and corneal keratinization, goblet cell loss, punctate keratitis, necrosis, and corneal ulceration . Such ocular-related complications due to alcohol could potentially lead to vision loss and reduced immune tolerance, consequently increasing LOS …”

Section: Discussionmentioning

confidence: 99%

“…Chronic consumption of alcohol has been linked to vitamin A deficiency via the induction of ethanol-inducible cytochrome P-450 in the liver, leading to morphologic changes on the ocular surface in the form of conjunctival and corneal keratinization, goblet cell loss, punctate keratitis, necrosis, and corneal ulceration. 25 Such ocular-related complications due to alcohol could potentially lead to vision loss and reduced immune tolerance, consequently increasing LOS. [26][27][28][29][30] Although cocaine use has been associated with corneal complications such as corneal ulceration, epithelial defects, corneal infiltration, and infectious keratitis, 25 our analysis found that these patients had a shorter LOS.…”

Section: Discussionmentioning

confidence: 99%

“…25 Such ocular-related complications due to alcohol could potentially lead to vision loss and reduced immune tolerance, consequently increasing LOS. [26][27][28][29][30] Although cocaine use has been associated with corneal complications such as corneal ulceration, epithelial defects, corneal infiltration, and infectious keratitis, 25 our analysis found that these patients had a shorter LOS. Although the exact reason for this trend is unclear, we find that one contributing factor may be this population's tendency to leave hospital care against medical advice.…”

Section: Discussionmentioning

confidence: 99%

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Sociodemographic and Clinical Predictors of Prolonged Length of Corneal Ulcer Hospitalizations

Akosman,

Li,

Kwon

et al. 2024

JAMA Ophthalmol

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ImportanceThe length of stay (LOS) of hospitalizations may be a useful indicator of the burden of disease of corneal ulcers. Identifying variables associated with longer LOS may help to enhance delivery of care for high-risk patients.ObjectiveTo investigate the sociodemographic, social, and clinical factors associated with LOS in hospitalizations for corneal ulcers in the US.Design, Setting, and ParticipantsThis was a retrospective cross-sectional study of adult patients (aged &gt;18 years) admitted with a primary diagnosis of corneal ulcer between quarter 4 of 2015 through 2020 and conducted using data from the National Inpatient Sample (NIS). Patients were stratified into 2 even cohorts based on LOS: LOS of 4 days or less and LOS greater than 4 days. Individual-level sociodemographic, social risk factors, and medical comorbidities associated with longer LOS were examined by multivariable regression. Data were analyzed from October 2015 to December 2020.ExposurePotential sociodemographics or medical comorbidities at hospital admission.Main Outcome and MeasureThe primary outcome of interest was factors associated with extended length of stay. The hypothesis being tested was formulated during data collection.ResultsA total of 1187 patients (mean [SD] age, 53.5 [20.9] years; 602 female [50.7%]) were included for analysis. The cohort with LOS greater than 4 days had higher total charges than the cohort with LOS of 4 days or less (mean [SD] charges, $79 504 [$86 719] vs $26 474 [$20 743]; P &lt; .001). Sociodemographic variables associated with LOS greater than 4 days were Black race (adjusted odds ratio [aOR], 1.41; 95% CI, 1.03-1.92; P = .03), Medicare insurance (aOR, 1.42; 95% CI, 1.09-1.85; P = .009), and housing insecurity (aOR, 1.99; 95% CI, 1.29-3.06; P = .002). Medical comorbidities associated with LOS greater than 4 days were alcohol use (aOR, 1.50; 95% CI, 1.00-2.26; P = .05), dementia (aOR, 2.35; 95% CI, 1.36-4.07; P = .002), complicated diabetes (aOR, 1.75; 95% CI, 1.21-2.53; P = .003), uncomplicated diabetes (aOR, 1.57; 95% CI, 1.02-2.42; P = .04), drug misuse (aOR, 1.66; 95% CI, 1.08-2.57; P = .02), and legal blindness (aOR, 3.42; 95% CI, 1.19-9.82; P = .02). Based on NIS national estimates, corneal ulcers were estimated to have a direct annual health care expenditure of $35 819 590 in the US.Conclusion and RelevanceCorneal ulcer hospitalizations represent a significant burden of disease for patients and health care systems. This study highlights sociodemographic and clinical factors that may help clinicians identify high-risk patients vulnerable to complications and morbidity due to corneal ulcers.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Sociodemographic and Clinical Predictors of Prolonged Length of Corneal Ulcer Hospitalizations

Akosman,

Li,

Kwon

et al. 2024

JAMA Ophthalmol

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“…Meibomian gland dysfunction (MGD) may be determined by observing the morphological structure of the glands and assessing their appearance and function on the eyelid margin, where the orifices of the glands are located and the meibum is secreted [12]. Signs of EDE and ADDE may overlap in the most severe cases of DED, which are highly prevalent in women and those of advanced age [13][14][15]. The meibomian glands suffer from various age-related changes, including meibomian gland atrophy and dropout and decreased acinar cell proliferation [13,15].…”

Section: Introductionmentioning

confidence: 99%

“…Signs of EDE and ADDE may overlap in the most severe cases of DED, which are highly prevalent in women and those of advanced age [13][14][15]. The meibomian glands suffer from various age-related changes, including meibomian gland atrophy and dropout and decreased acinar cell proliferation [13,15]. Moreover, a reduction in tear production seems to occur later in life, close to 50 years old [14].…”

Section: Introductionmentioning

confidence: 99%

A Comprehensive Study on Tear Meniscus Height Inter-Eye Differences in Aqueous Deficient Dry Eye Diagnosis

Pena-Verdeal,

Garcia-Queiruga,

Sabucedo-Villamarin

et al. 2024

JCM

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(1) Background: Dry eye disease (DED) is a chronic ocular surface condition that requires precise diagnostic tools. The present study aimed to investigate the diagnostic potential of the absolute inter-eye difference (|OD-OS|) in tear meniscus height (TMH) for the detection of the presence of aqueous deficient dry eye (ADDE). (2) Methods: A sample of 260 participants with dry eye complaints underwent ocular surface examinations thorough diagnostic assessments based on the Tear Film and Ocular Surface Society guidelines (TFOS DEWS II). Participants were subsequently categorized as No ADDE and ADDE based on TMH. Statistical analyses to determine the optimal TMH|OD-OS| cut-off value in a randomly selected study group (200 participants) were performed, while a separate validation analysis of the cut-off value obtained in a random cross-validation group (60 participants) was also performed. (3) Results: The significant diagnostic capability of TMH|OD-OS| (area under the curve = 0.719 ± 0.036, p < 0.001) was found. The identified cut-off value of 0.033 mm demonstrated reliable specificity (77.6%) and moderate sensitivity (59.1%). Cross-validation confirmed the cut-off value’s association with the TFOS DEWS II diagnostic criterion (Cramer’s V = 0.354, p = 0.006). (4) Conclusions: The present study provides evidence for the diagnostic potential of TMH|OD-OS| in identifying ADDE. The identified cut-off value enhances the specificity and offers moderate sensitivity, providing an objective tool for clinical decision making.

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Dry Eye Disease—Clinical Diagnosis and Management

Craig,

Wolffsohn

2024

Reference Module in Neuroscience and Biobehavioral Psychology

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TFOS Lifestyle: Impact of societal challenges on the ocular surface

Cited by 27 publications

References 524 publications

Sociodemographic and Clinical Predictors of Prolonged Length of Corneal Ulcer Hospitalizations

Sociodemographic and Clinical Predictors of Prolonged Length of Corneal Ulcer Hospitalizations

A Comprehensive Study on Tear Meniscus Height Inter-Eye Differences in Aqueous Deficient Dry Eye Diagnosis

Dry Eye Disease—Clinical Diagnosis and Management

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