Abstract
Purpose :
To evaluate the normal distribution of tear fluid quantity in a 3-minute and a 5-minute ST in a large cohort of the general population and to test whether Schirmer test (ST) results are associated with topical or systemic medication and.
Methods :
ST was performed in a sub-cohort of the Gutenberg Health Study which is a population-based, prospective, observational cohort study in Germany, including 15,010 participants aged between 35 and 74 at baseline. ST was performed under topical anesthesia and with a duration time of 5 minutes (ST-5) or of 3 minutes (ST-3). Anthropometric factors and history of systemic diseases, use of eye and systemic medications were recorded. Quantile regression analysis was used to assess the influence of age, sex, socioeconomic status, diabetes, smoking, ophthalmic and systemic medication on ST measurements.
Results :
Tear fluid quantity as assessed by length of wetting of the Schirmer strips for ST-5 was 23.2 ± 9.31 mm for right eyes and 22.9 ± 9.0 mm for left eyes. In ST-3, the measurements were 20.0 mm in right eyes and 19.1 mm in left eyes. The clinical cut off of 10 mm for ST-5 corresponded with an 8 mm cut off for ST-3 testing.
While smaller ST-5 measures were associated with male sex, higher age, socioeconomic status and season (all p<0.001), there was no association with diabetes or smoking. The use of prostaglandin or beta-blocker eye drops or oral non-steroidal anti-inflammatory drugs, drugs for peptic ulcer and gastro-oesophageal reflux disease, thyroid hormones, progesterone and estrogen combination drugs, and hypnotics and sedatives showed an association with smaller ST-5.
Conclusions :
For the first time we present the distribution of tear fluid quantity by ST in a very large cohort of the general population. Furthermore, we found associations of ST measures with topical and systemic medication.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.