Takenori Inomata1, Masao Iwagami2, Masahiro Nakamura3, Tina Shiang4, Keiichi Fujimoto5, Yuichi Okumura6, Nanami Iwata5, Kenta Fujio5, Yoshimune Hiratsuka7, Satoshi Hori8, Kazuo Tsubota9, Reza Dana10, Akira Murakami7. 1. Juntendo University Faculty of Medicine, Department of Ophthalmology, Tokyo, Japan; Juntendo University Faculty of Medicine, Department of Strategic Operating Room Management and Improvement, Tokyo, Japan. Electronic address: tinoma@juntendo.ac.jp. 2. Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan; Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. 3. Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan. 4. Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA. 5. Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan. 6. Juntendo University Faculty of Medicine, Department of Strategic Operating Room Management and Improvement, Tokyo, Japan; Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan. 7. Juntendo University Faculty of Medicine, Department of Ophthalmology, Tokyo, Japan. 8. Department of Electric Medical Intelligence Management, Juntendo University Faculty of Medicine, Tokyo, Japan. 9. Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. 10. Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
Abstract
PURPOSE: Dry eye (DE) disease and depression are increasing in modern times. We investigated the association between DE and depressive symptoms using the iPhone application, DryEyeRhythm. METHODS: This large-scale crowdsourced observational study was conducted within iPhone users in Japan who downloaded DryEyeRhythm. Participants with a Zung Self-rating Depression Scale (SDS) score ≥ 40 were defined as having depressive symptoms, and those with an Ocular Surface Disease Index (OSDI) score ≥ 13 were defined as having DE symptoms (mild, 13-22; moderate, 23-32; and severe, 33-100). We compared SDS scores between participants with normal eye and mild, moderate, and severe OSDI-based DE symptoms. Logistic regression analyses were used to determine the association between DE severity and depressive symptoms after adjustment for demographic characteristics, medical history, and lifestyle habits. RESULTS: This study included 4454 participants (mean age, 27.9 ± 12.6 years; female, 66.7%). Participants with SDS scores ≥40 accounted for 58.2%, 70.9%, 79.4%, and 85.0% of normal controls and participants with mild, moderate, and severe DE symptoms, respectively (P trend < 0.001). The adjusted odds ratios (95% confidence interval) for depressive symptoms (SDS score of ≥40) were 1.62 (1.35-1.95) for mild, 2.39 (1.92-2.97) for moderate, and 3.29 (2.70-4.00) for severe DE symptoms. CONCLUSION: This large-scale crowdsourced clinical study using DryEyeRhythm suggests that depressive symptoms are more common in individuals with more severe DE symptoms. DryEyeRhythm could play a role in earlier prevention or future prospective interventions for depressive symptoms in individuals with DE symptoms.
PURPOSE:Dry eye (DE) disease and depression are increasing in modern times. We investigated the association between DE and depressive symptoms using the iPhone application, DryEyeRhythm. METHODS: This large-scale crowdsourced observational study was conducted within iPhone users in Japan who downloaded DryEyeRhythm. Participants with a Zung Self-rating Depression Scale (SDS) score ≥ 40 were defined as having depressive symptoms, and those with an Ocular Surface Disease Index (OSDI) score ≥ 13 were defined as having DE symptoms (mild, 13-22; moderate, 23-32; and severe, 33-100). We compared SDS scores between participants with normal eye and mild, moderate, and severe OSDI-based DE symptoms. Logistic regression analyses were used to determine the association between DE severity and depressive symptoms after adjustment for demographic characteristics, medical history, and lifestyle habits. RESULTS: This study included 4454 participants (mean age, 27.9 ± 12.6 years; female, 66.7%). Participants with SDS scores ≥40 accounted for 58.2%, 70.9%, 79.4%, and 85.0% of normal controls and participants with mild, moderate, and severe DE symptoms, respectively (P trend < 0.001). The adjusted odds ratios (95% confidence interval) for depressive symptoms (SDS score of ≥40) were 1.62 (1.35-1.95) for mild, 2.39 (1.92-2.97) for moderate, and 3.29 (2.70-4.00) for severe DE symptoms. CONCLUSION: This large-scale crowdsourced clinical study using DryEyeRhythm suggests that depressive symptoms are more common in individuals with more severe DE symptoms. DryEyeRhythm could play a role in earlier prevention or future prospective interventions for depressive symptoms in individuals with DE symptoms.