People under 18 years-of-age with aqueous deficient dry eye disease (DED), particularly young women, those with diabetes and autoimmune diseases, are at the highest risk of corneal surface damage, according to a 17-year population-based study completed in Taiwan.
DED increases the risk of corneal surface damage, such as recurrent corneal erosion, corneal ulcers, or corneal scars. Its prevalence increases with age, especially in patients older than 65 years.
The retrospective, population based cohort study analysed data in the Taiwan National Health Insurance Research Database from 1997 to 2013 of patients with DED, defined according to diagnoses, drug codes, and clinical follow-up. A comparison cohort without DED was selected through propensity score matching. The main outcome measures were corneal surface damage, including corneal erosion, corneal ulcers, or corneal scars.
The study reported that patients with DED had a significantly higher rate of corneal surface damage (HR: 2.70; 95% CI 2.38-3.06, P < .001), especially higher in patients <18 years (HR 6.66; 95% CI 3.58-12.41) than in older patients and in women (HR 2.98; 95% CI 2.57 -3.46) than in men (HR 2.22; 95% CI 1.78-2.77) compared to those in the non-DED cohort. DED with diabetes mellitus (P = .002), rheumatic arthritis (P = .029), or systemic lupus erythematosus (P = .005) was positively associated with corneal surface damage. The overall prevalence of DED was 7.85%, higher among women (10.49%) than men (4.92%), and increased with age (0.53%, 3.94%, 10.08%, and 20.72% for ages of <18, 18-39, 40-64, and >65 years, respectively). The prevalence increased gradually during the study period.
- Ning Hung, Eugene Yu-Chuan Kang, Tay-Wey Lee. Tien-Hsing Chen, Yu-Chiau Shyu, Chi-Chin Sun. The risks of corneal surface damage in aqueous deficient dry eye disease: A 17-year population-based study in Taiwan. American Journal of Ophthalmology 2021DOI:https://doi.org/10.1016/j.ajo.2021.03.013