Sara Tellefsen Nøland1, Reza A Badian2, Tor P Utheim3, Øygunn A Utheim4, Aleksandar Stojanovic5, Behzod Tashbayev6, Sten Raeder7, Darlene A Dartt8, Xiangjun Chen9. 1. Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. Electronic address: sara.tellefsen@studmed.uio.no. 2. Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; National Centre for Vision, Optics and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway. 3. Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; National Centre for Vision, Optics and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway; Department of Ophthalmology, Vestre Viken Hospital Trust, Drammen, Norway; Department of Ophthalmology, Oslo University Hospital, Oslo, Norway; Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway; Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway; Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway. 4. Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, Oslo University Hospital, Oslo, Norway; The Norwegian Dry Eye Clinic, Oslo, Norway. 5. Department of Ophthalmology, University Hospital of North Norway, Tromsø, Norway. 6. Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway. 7. The Norwegian Dry Eye Clinic, Oslo, Norway. 8. Schepens Eye Research Institute/Massachusetts Eye and Ear/Department of Ophthalmology, Harvard Medical School, Boston, MA, United States. 9. National Centre for Vision, Optics and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway; Department of Ophthalmology, Vestre Viken Hospital Trust, Drammen, Norway; Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway; The Norwegian Dry Eye Clinic, Oslo, Norway; Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway.
Abstract
PURPOSE: To investigate sex and age differences in symptoms and signs in a Norwegian clinic-based cohort of patients with dry eye disease (DED). METHODS: Visitors at the Norwegian Dry Eye Clinic were examined using Ocular Surface Disease Index (OSDI) questionnaire score, tear osmolarity, tear break-up time (TFBUT), ocular surface staining, corneal sensitivity, Schirmer I test, and meibum expressibility (ME) and quality (MQ). A diagnosis of DED was made by an ophthalmologist based on symptoms and signs, and only DED patients were enrolled in the study: 1823 patients (338 males; mean age 51.2 ± 16.2 years; 1485 females; mean age 52.5 ± 16.0 years). The patients were divided into age subgroups: 20-39 years, 40-59 years and ≥60 years. Sex differences in the aforementioned tests were analyzed. Values were reported as mean ± standard deviation (SD), and intergroup comparisons were performed using Mann-Whitney U test. Multiple regression was used to analyze sex and age influences on symptoms and signs. RESULTS: When patients of all ages were analyzed, females had increased osmolarity, shorter TFBUT, reduced MQ and ME and higher corneal sensitivity. OSDI, Schirmer I test, ocular surface staining and corneal staining were not significantly different between the sexes. Only with TFBUT and ME were the sex difference present in all age subgroups. Multiple regression showed that all parameters were influenced by either sex or age, but only TFBUT and ME were influenced by both sex and age. (all p < 0.05). CONCLUSIONS: Sex and age differences in dry eye were most consistent in TFBUT and ME, that indicate differences in meibomian gland functionality. Sex and age subgroup stratification is important in future studies investigating DED in other populations.
PURPOSE: To investigate sex and age differences in symptoms and signs in a Norwegian clinic-based cohort of patients with dry eye disease (DED). METHODS: Visitors at the Norwegian Dry Eye Clinic were examined using Ocular Surface Disease Index (OSDI) questionnaire score, tear osmolarity, tear break-up time (TFBUT), ocular surface staining, corneal sensitivity, Schirmer I test, and meibum expressibility (ME) and quality (MQ). A diagnosis of DED was made by an ophthalmologist based on symptoms and signs, and only DED patients were enrolled in the study: 1823 patients (338 males; mean age 51.2 ± 16.2 years; 1485 females; mean age 52.5 ± 16.0 years). The patients were divided into age subgroups: 20-39 years, 40-59 years and ≥60 years. Sex differences in the aforementioned tests were analyzed. Values were reported as mean ± standard deviation (SD), and intergroup comparisons were performed using Mann-Whitney U test. Multiple regression was used to analyze sex and age influences on symptoms and signs. RESULTS: When patients of all ages were analyzed, females had increased osmolarity, shorter TFBUT, reduced MQ and ME and higher corneal sensitivity. OSDI, Schirmer I test, ocular surface staining and corneal staining were not significantly different between the sexes. Only with TFBUT and ME were the sex difference present in all age subgroups. Multiple regression showed that all parameters were influenced by either sex or age, but only TFBUT and ME were influenced by both sex and age. (all p < 0.05). CONCLUSIONS: Sex and age differences in dry eye were most consistent in TFBUT and ME, that indicate differences in meibomian gland functionality. Sex and age subgroup stratification is important in future studies investigating DED in other populations.
Authors: Menglu Yang; Haakon K Fjærvoll; Ketil A Fjærvoll; Nicholas H Wang; Tor P Utheim; Charles N Serhan; Darlene A Dartt Journal: Sci Rep Date: 2022-09-29 Impact factor: 4.996