Why the symptoms and objective signs of dry eye disease may not correlate

McMonnies, Charles W.

doi:10.1016/j.optom.2020.10.002

Cited by 26 publications

(23 citation statements)

References 82 publications

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“…Kim et al ( 28 ) suggested that depression was related to DED symptoms rather than signs. A review by McMonnies ( 29 ) also showed that dry eye features in patients with mental disorders were mostly severe symptoms and relatively mild signs. In addition, other studies have found that patients with depression, anxiety, and obsessive-compulsive disorder had more severe signs and symptoms of DED than the controls ( 11 , 30 ).…”

Section: Discussionmentioning

confidence: 99%

Dry Eye Disease in Patients With Schizophrenia: A Case-Control Study

Chen

Wei²,

Wang

et al. 2022

Front. Med.

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ObjectiveTo evaluate the clinical features and inflammatory cytokines of dry eye disease (DED) in patients with schizophrenia.MethodsThis is a case-control study. The modified self-rating depression scale (M-SDS) and the ocular surface disease index (OSDI) were used to evaluate the symptoms of depression and DED, respectively. Lipid layer thickness (LLT), partial blink rate (PBR), meibomian gland loss (MGL), tear break-up time (TBUT), corneal fluorescein staining, Schirmer I-test, and eyelid margin abnormalities were also measured. A multiplex ELISA Quantibody array was used to detect the inflammatory cytokines in the tears of all participants.ResultsForty schizophrenic patients and 20 control subjects were included. The mean age was 45.0 ± 9.5 years (range, 22–63 years) in schizophrenic patients and 45.4 ± 16.2 years (range, 23–76 years) in controls (P = 0.914). The ratio of male to female was 1.1 in schizophrenic patients and 1.0 in controls (P = 0.914). Ten women (52.6%) with schizophrenia and 2 (20%) in the control group (P = 0.096) were menopausal or post-menopausal. The OSDI [0.0 (0.0–4.2) vs. 7.3 (2.1–14.6)] and TBUT [4.5 (3.0–6.0) vs. 10.0 (3.5–11.0)] were significantly lower in patients with schizophrenia than in controls (P = 0.003 and P = 0.009, respectively). The rate of MGL [36.5 (17.5–47.5) vs. 8.5 (0.0–17.5)] increased in schizophrenic patients (P < 0.001). Among pro-inflammatory cytokines, the levels of interleukin (IL)-1α, IL-6, IL-11, IL-12A, IL-15, IL-17A, and granulocyte colony-stimulating factor (G-CSF) in tears were elevated in the schizophrenia group (all P < 0.01). Most of the chemokines examined were at increased levels in the tears of schizophrenics (all P < 0.05). The levels of matrix metalloproteinases-9 (MMP-9) and intercellular adhesion molecule-1 (ICAM-1) were also higher in the schizophrenic patients (all P < 0.001). The concentrations of IL-1Ra, tissue-inhibitor of metalloproteinase-1 (TIMP-1), and TIMP-2 in the schizophrenia group were decreased (all P < 0.001). In schizophrenic patients, the level of CCL2 in tears was positively correlated with OSDI (R = 0.34, P = 0.03). The increasing TIMP-1 and decreasing IL-5 were correlated with increasing LLT (R = 0.33, P = 0.035; R = −0.35, P = 0.027, respectively). The level of ICAM-1 was then positively correlated with partial blink rate (PBR) (R = 0.33, P = 0.035). There was a negative correlation between IL-8 and the Schirmer I-test (R = −0.41, P = 0.009).ConclusionsPatients with schizophrenia were more likely to experience asymptomatic DED, with mild symptoms and obvious signs. The inflammatory cytokines in the tears of schizophrenic patients differed greatly from that of non-schizophrenic patients.

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Section: Discussionmentioning

confidence: 99%

Dry Eye Disease in Patients With Schizophrenia: A Case-Control Study

Chen

Wei²,

Wang

et al. 2022

Front. Med.

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“…This may be due to differences in the study population, with adolescents likely to be more adept at accessing information from the internet. In addition, adolescents might have subjective symptoms of DED but do not meet the actual diagnostic criteria for field epidemiological studies ( 40 , 41 ). The frequency analysis of hot words related to DED mainly includes three aspects: other associated ocular diseases, treatment options and the subjective symptoms of patients.…”

Section: Discussionmentioning

confidence: 99%

Utilizing Baidu Index to Investigate Seasonality, Spatial Distribution and Public Attention of Dry Eye Diseases in Chinese Mainland

Zeng

Zhang

et al. 2022

Front. Public Health

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PurposeTo explore the characteristics of spatial-temporal prevalence and public attention of dry eye diseases (DED) through Baidu Index (BI) based on infodemiology method.MethodsThe data about BI of DED were collected from Baidu search engine using “Dry eye diseases” as keyword. The spatial and temporal distribution of DED were analyzed through timeseries data decomposition as well as spatial autocorrelation and hotspot detection of BI about DED. The most popular related words and demographic characteristics were recorded to determine the public attention of DED.ResultsThe trends of BI about DED in Chinese mainland had gradually increased over time with a rapid increase from 2012 to 2014 and in 2018. The results of timeseries decomposition indicated that there was seasonality in the distribution of BI about DED with the peak in winter, especially in northern regions. The geographic distribution demonstrated the search activities of DED was highest in the east of Chinese mainland while lowest in the west. The vast majority of people searching for DED were teenagers (20–29 years), with a predominance of females. Glaucoma, keratitis and conjunctivitis were the diseases most often confused with DED, and the artificial tears were the most common treatment for DED in Chinese mainland according to the BI about DED.ConclusionsThe analysis revealed the seasonality, geographic hotspots and public concern of DED through BI in Chinese mainland, which provided new insights into the epidemiology of DED.

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“…The symptoms and signs of dry eye disease may not always correlate, which is not well understood [ 42 ]. Regarding non-visual symptoms, the prevalence of discomfort increased probably due to mental stress and depression as a consequence of the pandemic [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

The ocular symptoms and signs during the COVID-19 pandemic

Ayaki

Negishi²

2022

PLoS ONE

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Purpose The aim of this cohort study was to describe the change in ocular surface signs and symptoms before and during the COVID-19 pandemic, and to associate changes with potential pandemic-related events. Methods First-visit patients from 2019 to 2021 were examined for corneal staining, lacrimal function and refraction. We assessed the presence of seven common ocular symptoms. Patients with glaucoma and macular disease were excluded. Dry eye (DE) was diagnosed according to the criteria of the Asia Dry Eye Society. Results The mean age of 3,907 participants was 59.6±18.6y and 63.8% were female. Mean age and the prevalence of diagnosed DE and shortened tear break-up time decreased from 2019 to 2021. The prevalence of eye fatigue, blurring and photophobia decreased in 2020. Conclusions The prevalence of diagnosed DE did not increase among first-visit patients during the pandemic compared with 2019, despite many survey results suggesting that DE may have worsened due to frequent masking, increased screen time, mental stress, and depression under quarantine and social infection control. It might be considered however, that many elderly DE patients might have refrained from consulting an ophthalmologist and possibly delayed treatment of DE during the pandemic.

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Why the symptoms and objective signs of dry eye disease may not correlate

Cited by 26 publications

References 82 publications

Dry Eye Disease in Patients With Schizophrenia: A Case-Control Study

Dry Eye Disease in Patients With Schizophrenia: A Case-Control Study

Utilizing Baidu Index to Investigate Seasonality, Spatial Distribution and Public Attention of Dry Eye Diseases in Chinese Mainland

The ocular symptoms and signs during the COVID-19 pandemic

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