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F. C. Figueiredo, C. Steeds, M. S. Figueiredo, D. E. Irwin, P. Buchhollz, J. G. Walt; The Treatment and Disease Progression of Patients With Moderate to Severe Dry Eye Disease Over Time in Routine Clinical Practice in the UK. Invest. Ophthalmol. Vis. Sci. 2007;48(13):6021.
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To evaluate the progression of keratoconjunctivitis sicca (KCS) over time in relation to the management of it’s symptoms.
This was a prospective, single-centre, registry of adults with moderate to severe KCS recruited between March 2002 and June 2005. No treatments were mandated as part of this study and patients were treated over time as in normal clinical practise. Clinical outcomes, medications used and severity assessment by the physician and patient were recorded at each routine clinic appointment. Patient reported outcomes included the Dry Eye Disease Impact Questionnaire (DEDIQ).
Analysis was conducted on 75 patients, of which 91% were female. The DEDIQ showed dry eye disease impact on daily activities and quality of life (QoL) increased with increasing disease severity. Patients assessed their dry eye disease as improved (38%; 46%), stayed the same (30%; 36%) or deteriorated (32%; 18%) at visit 2 (8 months) and visit 4 (16 months) respectively. Of the patients who deteriorated at 8 months, 89% were using single use artificial tears (ATs), 89% gels and 78% ointments for ≥28 days in the last month, and 39% used ATs ≥10 times/day. At 8 months, 45% of patients rated their dry eye as severe and of these, 88% used ATs, 81% gels and 69% ointments for ≥28 days in the last month, and 46% used ATs ≥10 times/day. In addition, 69% of moderate and severe patients had punctal plugs.
Dry eye disease cannot be cured and has a significant impact on patient’s activities and QoL. For many patients, current palliative dry eye medications help control or improve the symptoms of their dry eye disease. However, a significant number of moderate to severe dry eye patients in routine clinical practise still rate their KCS as deteriorating and / or severe despite extensive use of tear supplements. For these patients, current palliative treatments are not sufficient to control their dry eye symptoms and there is a need for therapeutic medications.
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