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Debra A Schaumberg, Moshe Fridman, Kimberly F Farrand; Comorbidities and Concomitant Medications in Dry Eye Disease. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6197.
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© ARVO (1962-2015); The Authors (2016-present)
Dry eye disease (DED) affects millions of Americans. To add to our understanding of common profiles of patients with DED, this study aimed to assess the association of DED with selected comorbid conditions and concomitant medications.
Adults (≥18 years) responded to the 2013 National Health and Wellness Survey, a self-administered internet-based questionnaire. Participants were asked if they had been diagnosed with dry eye by a physician. We compared the prevalence of comorbid conditions and use of concomitant medications among those with diagnosed DED versus those without a DED diagnosis or symptoms (non-DED), using chi-square tests for categorical variables and t tests for continuous variables. We used logistic regression models to estimate adjusted odds ratios (ORs) and 95% CIs of DED diagnosis controlling for age (18-34, 35-44, 45-54, 55-64, 65-74, ≥75), sex, insurance type (none, government, private, both, other), and other significant comorbidities (or concomitant medications).
Of the participants, N=5,042 reported a diagnosis of DED, and N=67,268 denied a DED diagnosis or symptoms. In unadjusted analyses, all selected comorbid conditions were associated with diagnosed DED (each P<0.001), for example: allergies (DED: 37% vs non-DED: 19%), autoimmune disease (47% vs 19%), high cholesterol (50% vs 28%), depression (24% vs 14%), anxiety (22% vs 13%), pain (48% vs 23%), and glaucoma (7% vs 2%). Associations remained significant in adjusted models, and there was a strong trend of higher odds of DED with increasing number of reported comorbid conditions (OR=2.08 for 1 comorbidity, 3.20 for 2, and 7.09 for ≥3, P-trend<0.0001; Figure 1). The adjusted odds of DED were also significantly higher across all medication classes examined except antipsychotics (Figure 2). In groupings of medications by indication, the OR (95% CI) of DED diagnosis for use of any allergy medications was 2.49 (2.29−2.70), depression and anxiety medications: 1.92 (1.79−2.07), and glaucoma medications: 2.46 (2.10−2.89).
Comorbidities such as allergy, autoimmune disease, high cholesterol, anxiety, pain, and glaucoma, as well as use of medications to treat these diseases, are more common among people with diagnosed DED. Awareness of these associations may inform more timely diagnosis and improved management of the millions of patients suffering with this disease.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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