Factors influencing subjective symptoms in dry eye disease

AIM: To retrospectively investigate the association between dry eye symptoms and clinical or in vivo confocal microscopy parameters in patients with dry eye disease(DED), and to compare these parameters between eyes with DED and normal subjects.METHODS: This retrospective, cross-sectional, controlled study comprised 25 consecutive patients with non-Sj?gren dry eye disease and age-and sex-matched 25 healthy subjects. Each patient underwent a complete examination of the ocular surface in the following order: tear osmolarity measurements, InflammaDry test, tear break-up time, corneal fluorescein staining, Schirmer I test, subjective symptoms questionnaire using the dry eye-related qualityof-life score(DEQS), and in vivo confocal microscopy analysis of the central cornea. Beck depression inventory(BDI) as depressive scale and history of medications and smoking were also evaluated. Stepwise multiple regression analysis was used to assess the factors affecting the DEQS.RESULTS: In univariate analysis, DEQS was associated with tear break-up time(ρ=-0.48, P=0.01), oral medications, such as hypotensive drug(ρ=0.56, P=0.004) and antidepressant(ρ=0.57, P=0.003), and BDI(ρ=0.61, P=0.001) in patients with DED. In multiple regression analysis, explanatory variables relevant to the DEQS were the anti-depressant medications(P=0.04, partial regression coefficient B=21.04) and BDI(P=0.02, B=0.76, adjusted R2=0.54) in these patients. CONCLUSION: Our study shows a significant association between depression and dry eye symptoms. It suggests that dry eye symptoms associate with higher depressive symptoms and its medications, although our patients were not followed longitudinally.

Systematic Review on the Epidemiology and Management of the Dry Eye Disease in Sub-Saharan Francophone Africa

Introduction: Dry Eye Disease (DED) is a multifactorial affection of the tears and the ocular surface. Its prevalence in the world varies between 7% and 33%. To the best of our knowledge, the prevalence of DED in Subsaharan Francophone African countries is not yet known. The objectives of this systematic review were to determine the prevalence of DED, to identify the main risk factors for DED, and to determine the diagnostic and therapeutic management of DED in Subsaharan Francophone African countries. Methodology: This is a systematic review of articles, dealing with DED, published in English or French language from 2010 to 2020. The following key words (Prevalence OR Incidence OR Proportion OR Rate OR Frequency OR Epidemiology OR Distribution) AND (Risk Factors OR Influences) AND (Symptoms or Questionnaire) AND (Clinical Signs OR Clinical Tests) AND (Dry Eye Disease OR Dry Eye Syndrome) AND (Pharmacological Treatment OR Non-pharmacological Treatment OR Management) AND (Benin OR Burkina Faso OR Burundi OR Cameroon OR Cap-Green OR Central African Republic OR Congo OR Congo (Democratic Republic of) OR Ivory Coast OR Gabon OR Guinea OR Guinea-Bissau OR Equatorial Guinea OR Mali OR Madagascar OR Mauritius (island) OR Niger OR Rwanda OR Sao Tome and Principe OR Senegal OR Seychelles OR Chad OR Togo) in French and English were searched on Pubmed, Chocrane database, Google scholar and ICTRP. Articles in English and French were selected from 2010 to 2020. Results: We selected 05 articles on the epidemiology and management of DED in sub-Saharan francophone Africa. The prevalence of DED in sub-Saharan francophone Africa in the articles ranged from 7.5% to 90.4%. DED affects more women than men. The risk factors found were: age over 50 years, diabetes, meibomian gland dysfunction, prolonged use of computers, and glaucomatous anti-glaucoma drugs. The Test of Breack Up Time (TBUT) was commonly used for the clinical diagnosis of dry eye disease in Sub-Saharan Francophone Africa. The therapeutic strategy for DED was not mentioned in any article. Conclusion: DED, a multifactorial and blinding eye disease, is insufficiently explored by eye health professionals in sub-Saharan Francophone Africa. The implementation of a systematic screening program and strategies for the treatment of dry eye disease in at-risk individuals would be beneficial for sub-Saharan Francophone African countries.