Abstract
Purpose :
Cyclical variations in dry eye symptoms over the menstrual cycle are not fully explained by ocular surface signs. The aim of this study was to determine the association between somatosensory function and dry eye symptoms, and how this changes over the menstrual cycle.
Methods :
This was a prospective 1-month observational study of 25 young healthy females with regular, 24 to 32-day menstrual cycles. Participants attended 3 visits at days 7, 14, and 21 (±1) of their menstrual cycle. At baseline, general health, lifestyle and pain questionnaires were conducted. At each visit, Ocular Surface Disease Index (OSDI), overall ocular comfort (OOC, visual analogue scale), ocular surface assessment, tear break-up time (TBUT) and quantitative sensory testing of the forehead and arm (warm and cold sensation and pain thresholds and ratings), were assessed.
Results :
A total of 25 participants (mean age=23 ± 4 years) completed the 3 visits. No signs, symptoms or somatosensory measures changed significantly over the three visits. The association of symptoms with signs and somatosensory function changed over the cycle. At the follicular phase (day 7), symptoms were correlated with ocular surface signs and lifestyle/general health; meibomian gland dysfunction (MGD) and OOC (r=0.59, p=0.002); MGD and OSDI (r=0.56, p=0.003); corneal staining and OOC (r=0.44, p=0.03); exercise and OOC (r=-0.53, p=0.007); general health and OOC and OSDI (r=0.41, p=0.04, both). At the ovulation phase (day 14), symptoms were correlated with somatosensory function and sleep quality; cold pain rating on the forehead and OOC (r=0.46, p=0.02); warm pain rating on the forehead and OOC (r=0.40, p=0.05); cold sensation threshold on the arm and OSDI (r=0.44, p=0.02); cold pain rating on the arm and OOC (r=0.58, p=0.002); sleep quality and OOC (r=0.47, p=0.02). At the luteal phase (day 21), symptoms were correlated with ocular surface signs; limbal hyperaemia and OSDI (r=0.47, p=0.02); general health and OOC and OSDI (r=0.45, p=0.03, and r=0.40, p=0.05 respectively).
Conclusions :
In agreement with a growing body of literature, we found that somatosensory function is associated with dry eye symptoms in young, healthy women, although only in the ovulation phase. The finding of no change in somatosensory measures, or ocular signs or symptoms across the cycle, but changes in their associations is unexpected and should be explored in future studies.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.