Age-associated Differences in Severity of Ocular Signs in Dry Eye Disease Patients

Abstract

Purpose: To investigate whether the severity of ocular signs in a Norwegian cohort of dry eye disease (DED) patients is associated with age.

Methods: DED patients were consecutively included in the study. All patients received an extensive ophthalmological work-up, including tear meniscus height, blink rate, corneal sensitivity, tear film break-up time (TFBUT), Ocular Protection Index (OPI), staining, Schirmer I, meibum quality, and meibum expressibility. Statistical analysis included MANCOVA.

Results: Three hundred and fifty one patients with DED of different etiologies were included. Patients were grouped according to age: group 1) 0 to 19 years (1%); group 2) 20 to 39 (25%); group 3) 40 to 59 (34%); group 4) 60 to 79 (35%); and group 5) 80 to 99 (5%). After controlling for effects of gender and polypharmacy, there were no differences between the five age-groups with respect to staining (P=0.936), TFBUT (P=0.121), blink interval (P=0.583), OPI (P=0.148), tear meniscus height (P=0.418), and meibum quality (P=0.758). Schirmer I decreased with increasing age in all but group 5: group 1 (27 ± 8; P<0.05 compared to all other groups), group 2 (18 ± 11; P<0.05 compared to group 1, 3 and 4), group 3 (14 ± 9; P<0.01 compared to group 1 and 2), group 4 (12 ± 8; P<0.001 compared to group 1 and 2), and group 5 (15 ± 7; P<0.01 compared to group 1). Corneal sensitivity was decreased in group 5 compared to all other groups (P<0.05). Meibum expressibility decreased with increasing age: group 1 (0 ± 0; P=0.025 compared to group 5), group 2 (0.4 ± 0.6; P<0.05 compared to group 3, 4 and 5), group 3 (0.7 ± 0.7; P=0.017 compared to group 2), group 4 (0.8 ± 0.8; P=0.001 compared to group 2) and group 5 (1.0 ± 0.8; P<0.05 compared to group 1 and 2).

Conclusions: Despite the prevalence of DED being highly age-dependent, the majority of the objective DED parameters assessed in this study did not show significant changes with increasing age.

Keywords: 486 cornea: tears/tear film/dry eye • 413 aging • 463 clinical (human) or epidemiologic studies: prevalence/incidence