Sex differences in clinical characteristics of dry eye disease

TY - JOUR

T1 - Sex differences in clinical characteristics of dry eye disease

AU - Vehof, Jelle

AU - Sillevis Smitt-Kamminga, Nicole

AU - Nibourg, Simone A.

AU - Hammond, Christopher J.

N1 - Copyright © 2018 Elsevier Inc. All rights reserved.

PY - 2018/4

Y1 - 2018/4

N2 - PURPOSE: To investigate the role of sex on the symptomatology of DED and on the associations between symptoms and signs.METHODS: A cross-sectional study was used including 755 dry eye patients from the Groningen Longitudinal Sicca Study (GLOSSY cohort). Patient symptoms were assessed by the Ocular Surface Disease Index (OSDI) questionnaire and dry eye signs by the six most commonly used tests. Patients were divided in groups based on overall severity of signs and within these groups total and specific symptoms were compared by sex. Sex differences in Spearman correlation between symptoms and signs were calculated.RESULTS: Women had higher total symptom scores than men in both the mild (33.8 vs 24.7, P = .01) and moderate signs groups (38.3 vs 28.0, P < .005), but this difference was less apparent in the severe signs group (40.4 vs 37.2, P = .33). Independent of severity of signs, women consistently reported more light sensitivity than men (P < .01 in all groups). The correlation between symptoms and overall severity of signs score was significantly lower in women (ρ = 0.11 vs ρ = 0.33 in men, P = .01), with clearest differences between women and men in correlations with Schirmer (ρ = 0.01 vs ρ = -0.21, P = .03) and TFBUT (ρ = -0.08 vs ρ = -0.30, P = .02).CONCLUSIONS: This large clinical study has shown that sex has a large influence on the symptomatology of DED, with significantly higher symptom scores and lower correlation between symptoms and signs in women compared to men. These findings are of importance in clinical practice and in conducting research into DED.

AB - PURPOSE: To investigate the role of sex on the symptomatology of DED and on the associations between symptoms and signs.METHODS: A cross-sectional study was used including 755 dry eye patients from the Groningen Longitudinal Sicca Study (GLOSSY cohort). Patient symptoms were assessed by the Ocular Surface Disease Index (OSDI) questionnaire and dry eye signs by the six most commonly used tests. Patients were divided in groups based on overall severity of signs and within these groups total and specific symptoms were compared by sex. Sex differences in Spearman correlation between symptoms and signs were calculated.RESULTS: Women had higher total symptom scores than men in both the mild (33.8 vs 24.7, P = .01) and moderate signs groups (38.3 vs 28.0, P < .005), but this difference was less apparent in the severe signs group (40.4 vs 37.2, P = .33). Independent of severity of signs, women consistently reported more light sensitivity than men (P < .01 in all groups). The correlation between symptoms and overall severity of signs score was significantly lower in women (ρ = 0.11 vs ρ = 0.33 in men, P = .01), with clearest differences between women and men in correlations with Schirmer (ρ = 0.01 vs ρ = -0.21, P = .03) and TFBUT (ρ = -0.08 vs ρ = -0.30, P = .02).CONCLUSIONS: This large clinical study has shown that sex has a large influence on the symptomatology of DED, with significantly higher symptom scores and lower correlation between symptoms and signs in women compared to men. These findings are of importance in clinical practice and in conducting research into DED.

KW - Dry eye disease

KW - Epidemiology

KW - Gender

KW - Neuropathic dry eye

KW - Sex

KW - Signs

KW - Symptoms

U2 - 10.1016/j.jtos.2018.01.001

DO - 10.1016/j.jtos.2018.01.001

M3 - Article

C2 - 29317327

SN - 1542-0124

VL - 16

SP - 242

EP - 248

JO - OCULAR SURFACE

JF - OCULAR SURFACE

IS - 2

ER -