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Julia Janecki, Anat Galor, Abigail Hackam, Bennie H Jeng, Naresh Kumar; Impact of the personal microenvironment on dry eye metrics. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2742.
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Dry eye (DE) disease is widely prevalent worldwide and there is growing evidence that environmental factors contribute to DE symptoms and signs. We performed a cross-sectional study to determine the effect of the personal microenvironment, as it relates to indoor air quality, on various DE symptoms and signs in Miami, Florida.
99 subjects with normal eyelid and corneal anatomy were recruited from the Miami Veterans Affairs Healthcare eye clinic from October 2017 to August 2018. During the clinic visit, symptoms of DE were assessed with standardized questionnaires and an ocular surface evaluation was conducted to measure tear osmolarity, tear breakup time, corneal epithelial cell disruption, tear production, eyelid parameters, and Meibomian gland atrophy. Within seven days of the clinic visit, a home visit was conducted to measure indoor air quality. An Aerocet Handheld Particle Counter was deployed for 90 minutes in the patient’s home. Environmental measures included number and size of airborne particles, humidity, and temperature. Correlational and multivariable linear regression analyses were performed to examine relationships between environmental and clinical metrics.
The majority of subjects were male (84%), black (56%), and non-Hispanic (67%). Dry eye symptoms in the population were in the mild-moderate range with a mean Dry Eye Questionnaire-5 score of 11±5. Environmental metrics varied widely between homes, with regard to particles counts, temperature, and humidity. Univariate correlational analysis revealed humidity significantly associated with Ocular Surface Disease Index (OSDI) scores (r=0.30, p<0.05), Schirmer score (r= -0.25 p<0.05), Meibomian gland dropout(r=0.27, p<0.05), eyelid vascularity(r=0.27, p<0.05), and inflammation(r=0.32, p<0.01), Particulate matter was not significantly associated with measured DE metrics. A multivariable linear regression revealed that humidity remained a significant predictor of DE symptoms and signs when considering demographics, co-morbidities, medications, and interaction variables. (Table 1).
Humidity was the indoor environmental metric most closely associated with multiple symptoms and signs of DE. Further studies should focus on whether modulating humidity may improve DE metrics in appropriate individuals.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
Forward Stepwise Multivariable analysis considering effects of environmental parameters on symptoms and signs of dry eye.
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