July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Is the Schirmer test associated with local and systemic medication? Results of the German population-based Gutenberg Health Study (GHS)
Author Affiliations & Notes
  • Ulrike Hampel
    Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  • Alexander Schuster
    Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  • Stefan Nickels
    Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  • Andreas Schulz
    Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
  • Karl J. Lackner
    Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
  • Thomas Münzel
    Center for Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
  • Philipp S. Wild
    Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
  • Manfred Beutel
    Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
  • Irene Schmidtmann
    Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
  • Norbert Pfeiffer
    Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  • Footnotes
    Commercial Relationships   Ulrike Hampel, None; Alexander Schuster, None; Stefan Nickels, None; Andreas Schulz, None; Karl J. Lackner, None; Thomas Münzel, None; Philipp S. Wild, None; Manfred Beutel, None; Irene Schmidtmann, None; Norbert Pfeiffer, None
  • Footnotes
    Support  The Gutenberg Health Study is funded through the government of Rhineland-Palatinate (“Stiftung Rheinland-Pfalz für Innovation“, contract AZ 961-386261/733), the research programs “Wissen schafft Zukunft” and “Center for Translational Vascular Biology (CTVB)” of the Johannes Gutenberg-University of Mainz, and its contracts with Boehringer Ingelheim and PHILIPS Medical Systems, including unrestricted grants for the Gutenberg Health Study. Philipp S. Wild is funded by the Federal Ministry of Education and Research (BMBF 01EO1503), and he is the PI of the German Center for Cardiovascular Research (DZHK).
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6766. doi:https://doi.org/
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      Ulrike Hampel, Alexander Schuster, Stefan Nickels, Andreas Schulz, Karl J. Lackner, Thomas Münzel, Philipp S. Wild, Manfred Beutel, Irene Schmidtmann, Norbert Pfeiffer; Is the Schirmer test associated with local and systemic medication? Results of the German population-based Gutenberg Health Study (GHS). Invest. Ophthalmol. Vis. Sci. 2019;60(9):6766. doi: https://doi.org/.

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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.

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