June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Incidence, persistence and resolution of dry eye disease: new insights into the natural history
Author Affiliations & Notes
  • Jelle Vehof
    Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
    Ophthalmology, University Medical Center Groningen, Groningen, Netherlands
  • Christopher J Hammond
    Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
  • Footnotes
    Commercial Relationships   Jelle Vehof, None; Christopher Hammond, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2700. doi:
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      Jelle Vehof, Christopher J Hammond; Incidence, persistence and resolution of dry eye disease: new insights into the natural history. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2700.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Studies on the incidence and natural history of dry eye disease (DED) are lacking and greatly needed. To gain more insight this longitudinal study assessed rates of incidence but also of resolution/persistence of DED and investigated associated risk factors.

Methods : 3136 subjects (mean age 59 yrs (SD 13), 91% female) from the population-representative TwinsUK cohort were assessed for DED at baseline and after 2 years. DED was assessed by questionnaires investigating (1) symptomatic DED, (2) a clinical diagnosis and treatment of DED, and (3) presence of DED by either a clinical diagnosis and/or both dryness and irritation symptoms constantly or often, as used by the Women’s Health Study (WHS). Incidence rates of DED were calculated, and the rate of resolution/persistence of symptomatic DED was calculated. Using logistic regression a wide range of demographic, environmental and dietary risk factors at baseline were tested for an association with incidence and persistence/resolution of DED (α=0.05).

Results : Of the 2310 subjects that had no DED at all at baseline, 2 years later 226 subjects had incident symptomatic DED (9.8%, 95%CI 8.6-11.1%), 81 had an incident clinical diagnosis and treatment of DED (3.5%, 95%CI 2.8-4.3%), and 94 had incident DED as defined by the WHS (4.1%, 95% CI 3.3-5.0%). Among the factors significantly associated with incidence of symptomatic DED were female sex, asthma, osteoarthritis, chronic pain syndromes, depression, higher copper intake, lower coffee intake, and increased BMI. Tear osmolarity at baseline, but not tear break-up time or Schirmer test, was associated with incidence of symptomatic DED.

Of the 615 subjects that had symptomatic dry eye disease at baseline, 228 showed resolution of symptoms 2 years later (37.1%, 95%CI 33.4-41.0%). Factors associated with persistence of symptomatic DED were osteoarthritis, increasing age, and female sex, where stroke, use of contact lenses, and higher coffee intake were associated with resolution of symptomatic DED.

Conclusions :
In this largely female sample we found high incidence, but also high resolution of symptomatic DED, indicating that symptomatic DED can be highly variable over time. Several factors associated with persistence, but also with resolution of symptomatic DED were found, indicating an associated chronic and temporarily/variable nature of DED, respectively.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.


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