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Jaime Martinez, Nallely Ramos Betancourt, Anat Galor, Francisco Beltran, Jorge Ozorno-Zarate, Valeria Sánchez Huerta, Marco Antonio Torres Vera, Everardo Hernandez-Quintela; Frequency and Risk Factors Associated with Ocular Surface Disease in Patients Attending a Tertiary Care Ophthalmology Center in Mexico City. Invest. Ophthalmol. Vis. Sci. 2013;54(15):961.
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The purpose of this study was to ascertain the frequency and risk factors for ocular surface disease (OSD) among patients in Mexico attending a tertiary care ophthalmology center.
200 consecutive patients seen in an ophthalmologic center in Mexico City from October 2012 to November 2012 underwent a comprehensive examination, including measurement of tear film break-up time (TBUT), fluorescein staining classified by Oxford scheme, Schirmer test type 1 and evaluation of Meibomian Gland Dysfunction (MGD). Symptoms of OSD were evaluated by the Ocular Surface Disease Index (OSDI) and Dry eye Questionnaire (DEQ-5). Information on demographics, exposures, past medical and ocular history, and medications was also collected. Symptomatic OSD was defined as having an OSDI score ≥23 or DEQ-5 score ≥12, clinical OSD was defined as having a Schirmer test <5, TBUT <5, or staining >1.
Mean patient age was 46.8 (±15.8) years (range, 16-85); 87 (47.3%) patients were male. The frequency of symptomatic OSD based on the OSDI score was 57%, with those aged 46-55 years most likely to have a positive OSDI (64%). The frequency of symptomatic OSD based on DEQ-5 was 28%, with those aged 36-45 years most likely to have a positive score (34% compared to 15% for those >66 years). Female gender imparted a 1.7 fold increased risk of disease as defined by the DEQ5 (95% CI 0.92-3.31, p-value 0.09). OSD based on clinical signs was seen at a frequency of 91%; 69% of patients had an MGD score >1. The use of a duodenal ulcer medication was found to be a risk factor for OSD using both the DEQ-5 and OSDI definitions (OR 2.8 and 13.1, p values < 0.05). Patients with diabetes mellitus had less OSD by the DEQ5 definition compared to their counterparts without diabetes (OR 0.12, 95% CI 0.02-0.98, p-value 0.047).
This is the first study to demonstrate the frequency of symptomatic and clinical OSD in a tertiary care ophthalmology center in Mexico. The frequency of OSD in our population ranged from 28% using a symptomatic definition to 91% using objective measures.
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