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Holly Inglis, Michael Friedlander, Stephanie L Watson; Dry Eyes and AIs. Invest. Ophthalmol. Vis. Sci. 2014;55(13):24.
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To test the hypothesis that women on aromatase inhibitors (AIs) for the treatment of breast cancer have a higher prevalence of dry eye syndrome (DES) compared to age-matched controls.
A cross-sectional analytical questionnaire-based study was performed. The exposure group consisting of women on AIs for the treatment of breast cancer were recruited from public hospital oncology clinics & private oncology rooms. A control group was recruited from women presenting to a public clinic for routine mammography screening. Exclusion criteria for both groups were a history of Sjogren's syndrome or recent eye infection. Women in the control group were excluded if they were not postmenopausal as AIs are only used in postmenopausal women. Demographic data (DOB, education, employment, country of birth, ethnicity), medical history (previous cancer treatment, current medications), & ocular history (previous dry eye symptoms, contact lens/ glasses use) were collected. The presence of DES was assessed using the ocular surface disease index (OSDI).
93 exposure group & 100 control group surveys were included. The groups were age-matched, with an average age of 62.3 years (control group) & 62.9 years (exposure group). The prevalence of DES (OSDI > 12) in the exposure group was 35% compared to 18% in the control group (p = 0.0036, 2-sample z-test). There was no significant difference in the severity of dry eyes between the two groups. Logistic regression analysis demonstrated that the odds of DES was 155% higher in the exposure group. None of the demographic data was significantly associated with DES. Patients who wore glasses for distance were also more likely to have DES.
DES is more prevalent in women on AIs for the treatment of breast cancer compared with age-matched controls. This has association has only previously been reported once in a retrospective case-control series. DES can significantly impact the quality of life of sufferers and, in this patient population, could potentially impact compliance, and thus may even indirectly affect recurrence rates. The OSDI presents a simple screening tool for oncologists to be able to assess their patients and refer accordingly. Awareness of this association will allow both oncologists and ophthalmologists to monitor patients and treat symptoms early thereby improving patient comfort and quality of life.
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