July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Environmental factors and symptoms and signs of dry eye disease at baseline in the Dry Eye Assessment and Management (DREAM©) Study
Author Affiliations & Notes
  • Joanne F Shen
    Department of Ophthalmology, Mayo Clinic in Arizona, Scottsdale, Arizona, United States
  • Erich Berg
    Medical School, Midwestern University, Glendale, Arizona, United States
  • Gui-Shuang Ying
    University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Perry Sheffield
    Icahn School of Medicine at Mount Sinai , New York, New York, United States
  • Loretta Szczotka-Flynn
    Department of Ophthalmology, University Hospitals, Cleveland, Ohio, United States
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 1963. doi:
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      Joanne F Shen, Erich Berg, Gui-Shuang Ying, Perry Sheffield, Loretta Szczotka-Flynn; Environmental factors and symptoms and signs of dry eye disease at baseline in the Dry Eye Assessment and Management (DREAM©) Study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1963.

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

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Abstract

Purpose :
To determine the association between environmental factors and dry eye symptoms and signs in subjects of the DRy Eye Assessment and Management (DREAM©) Study.

Methods : Moderate to severe dry eye (DE) subjects were evaluated at baseline with Ocular Surface Disease Index (OSDI), Brief Ocular Discomfort Index (BODI), conjunctival lissamine green staining, corneal fluorescein staining, tear film break up time (TBUT), and 5-minute Schirmer’s test with anesthesia. The same-day daily average temperature, humidity, wind speed, dew point, ozone, toxic and poisonous gases e.g. carbon monoxide, nitrogen oxides, sulfur dioxide, and particulate matter were abstracted from National Oceanic and Atmospheric Administration (NOAA) records. AOD (Aerosol Optical Depth, an air pollution equivalent) was abstracted from NOAA and NASA public sites, and total pollen was obtained from National Allergy Bureau (NAB) pollen counting stations. The Pearson correlation coefficient (ρ) was used for assessing statistical significance.

Results : Among 535 subjects, 81% were female, and mean age was 58 years. Of the DE symptoms (Table 1), the OSDI subscale of environmental triggers were inversely correlated with humidity (ρ=-0.13, p<0.01) and total pollen count (ρ =0.25, p<0.01). BODI was correlated with total pollen count (ρ=0.18, p<0.05). Of DE signs (Table 2), corneal fluorescein dye staining was inversely correlated with humidity (ρ=-0.16, p<0.001). TBUT was positively correlated with both humidity and dew point (ρ =0.20, p<0.001; ρ=0.18, p<0.001, respectively), but was inversely correlated with AOD (ρ=-0.22, p<0.001).

Conclusions : For DREAM© subjects, DE symptoms were correlated with local pollen count at baseline visit. Of DE signs, lissamine green and Schirmer’s tests had no statistical correlation to weather, pollution, and pollen, but TBUT and to a lesser degree corneal staining were associated with environmental factors. These findings confirm long-held clinical suspicions and the results of retrospective studies on the negative impact of environmental factors on DE symptoms. For DE patients in polluted, pollinated, and arid climates, strategies directed at control of environmental triggers may be beneficial.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Table 1: Correlation of environment measures with OSDI and BODI symptom scores

Table 1: Correlation of environment measures with OSDI and BODI symptom scores

 

Table 2: Correlation of environment measures with dry eye signs

Table 2: Correlation of environment measures with dry eye signs

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