June 2020
Volume 61, Issue 7
ARVO Annual Meeting Abstract  |   June 2020
Incidence of Dry Eye Disease Among Patients with Continuous Positive Airway Pressure or Other Nasal Mask Therapy Devices to Treat Sleep Apnea in the United States
Author Affiliations & Notes
  • Cynthia Matossian
    Matossian Eye Associates, Doylestown, Pennsylvania, United States
  • Xue Song
    IBM Watson Health, Massachusetts, United States
  • Ishveen Chopra
    IBM Watson Health, Massachusetts, United States
  • Abayomi Ogundele
    Sun Pharmaceutical Industries, Inc., New Jersey, United States
  • Footnotes
    Commercial Relationships   Cynthia Matossian, Aerie Pharmaceuticals (C), Alcon (C), Bausch Lomb (C), Bruder Healthcare (C), Checked Up (C), EyePoint (C), EyeVance (C), Johnson & Johnson (C), Kala Pharmaceuticals (C), Lacriscience (C), Lenstec (C), Lumenis (C), Novartis Pharmaceuticals (C), Ocular Science (C), Ocular Therapeutix Inc (C), Olympic (C), Progressive Tech Training (I), Quidel (C), Strathspey Crown (I), Sun Pharmaceuticals (C), TearLab (C), TissueTech (C), Veterinarian Recommended Solutions (I), Zeiss (C); Xue Song, IBM Watson Health (E), Sun Pharmaceutical Industries, Inc. (F); Ishveen Chopra, IBM Watson Health (E), Sun Pharmaceutical Industries, Inc. (F); Abayomi Ogundele, Sun Pharmaceutical Industries, Inc. (E)
  • Footnotes
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Investigative Ophthalmology & Visual Science June 2020, Vol.61, 157. doi:
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      Cynthia Matossian, Xue Song, Ishveen Chopra, Abayomi Ogundele; Incidence of Dry Eye Disease Among Patients with Continuous Positive Airway Pressure or Other Nasal Mask Therapy Devices to Treat Sleep Apnea in the United States. Invest. Ophthalmol. Vis. Sci. 2020;61(7):157.

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

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Purpose : The use of continuous positive airway pressure (CPAP) or other nasal mask therapy (NMT) devices are effective treatment options for sleep apnea. However, the constant leakage of air from the vents and sides of these devices flows past the eyes, which can lead to increased ocular surface dryness and precipitate dry eye signs and symptoms. The purpose of the study was to examine the incidence rates of dry eye disease (DED) in patients who use CPAP or NMT devices to treat sleep apnea in the United States (U.S.).

Methods : Using the IBM® MarketScan claims database, patients aged ≥18 years with ≥ 1 claim of CPAP or other NMT devices after a diagnosis of sleep apnea between 2013 and 2018 were identified. The date of the first CPAP claim was considered the index date. All patients had ≥12 months medical and pharmacy benefit in both the pre- and post-index periods, and no DED diagnosis in the pre-index period. Descriptive analysis included incidence rate (IR) of DED, reported for overall sample, and by index year, age, gender and DED related comorbidities.

Results : A total of 330,926 patients were selected, 65% were male, median age was 53 years. Most common comorbid conditions were diabetes (22%) and chronic pulmonary disease (COPD) (18%). The 1-, 2-, and 3-year IR of DED were 4.0%, 7.3%, and 10.3%, respectively. The 1-year IR of DED was 4.3%, 4.0%, 3.8% and 3.4% in index year 2014, 2015, 2016, and 2017, respectively. Incidence of DED increased with age; 1-year IR ranging from 1.6% in the ‘18-24’ to 11.2% in the ‘75+’ age group. Incidence of DED was higher among female than male (1-year IR: 5.8% vs. 3.0%). Among CPAP users who had psoriasis, chronic obstructive pulmonary disease, irritable bowel syndrome, diabetes or rheumatoid arthritis, the 1-year IR of DED were 9.1%, 5.4%, 5.3%, 5.1%, and 5.0%, respectively.

Conclusions : The incidence of DED in CPAP or NMT device users is higher than within the general population and increases over time. Sleep apnea device users who were female, older, or had comorbid inflammatory or metabolic conditions may experience a higher incidence of DED.

This is a 2020 ARVO Annual Meeting abstract.


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