June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Association between depression and severity of dry eye symptoms and signs among patients in the Dry Eye Assessment and Management (DREAM) Study
Author Affiliations & Notes
  • Yi Zhou
    University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
  • Maureen G Maguire
    Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • James Murrough
    Icahn School of Medicine at Mount Sinai Department of Psychiatry, New York, New York, United States
  • Yinxi Yu
    Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Neeta Roy
    Department of Ophthalmology, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Rony R Sayegh
    Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
  • Penny A Asbell
    Department of Ophthalmology, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Gui-Shuang Ying
    University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Yi Zhou, None; Maureen Maguire, None; James Murrough, None; Yinxi Yu, None; Neeta Roy, None; Rony Sayegh, Allergan (R), Novartis (R); Penny Asbell, None; Gui-Shuang Ying, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1226. doi:
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      Yi Zhou, Maureen G Maguire, James Murrough, Yinxi Yu, Neeta Roy, Rony R Sayegh, Penny A Asbell, Gui-Shuang Ying; Association between depression and severity of dry eye symptoms and signs among patients in the Dry Eye Assessment and Management (DREAM) Study. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1226.

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

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Abstract

Purpose : Depression is a common and serious medical condition more prevalent in dry eye disease (DED) patients than the general population. To further elucidate the relationship between depression and DED, we performed a secondary longitudinal analysis to assess the association of the severity of DED symptoms and signs with depression in participants of the multi-center Dry Eye Assessment and Management (DREAM) Study.

Methods : Ocular Surface Disease Index (OSDI) and the Brief Ocular Discomfort Index (BODI) were administered at baseline, 6 and 12 months. Clinical signs of DED were evaluated in each eye by corneal fluorescein staining, tear break-up time, Schirmer’s test, conjunctival lissamine green staining, meibomian gland abnormality, and tear osmolarity. Patients scoring ≤42 on the Mental Component Summary (MCS) of the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) were considered positive for depression based on the SF-36 user manual guidelines. We compared the score of DED symptoms, signs, and composite severity score of signs between patients with and without depression using generalized linear models adjusted for age, gender, race, time, and longitudinal observations per person. Effect sizes ([mean difference]/[SD]) were calculated to assess the magnitude of their associations.

Results : Among 535 patients with moderate to severe DED, 15.7% had depression at baseline, 17.3% at 6 months and 13.2% at 12 months. When baseline, 6 and 12 months data were combined, patients with depression had worse DED symptoms (P<0.001), ocular discomfort (P<0.001), composite severity score of DED signs (P=0.006), and corneal staining scores (P=0.02) compared to patients without depression (Table 1). The effect size for the OSDI (0.45) and BODI (0.46) were larger than for the composite severity score of signs (0.21) (Table 1). Lower MCS scores (i.e., higher likelihood of depression) were significantly correlated with higher OSDI score (i.e., worse DED symptoms) at baseline (Spearman ρ=-0.09, P=0.03), 6 months (ρ=-0.20, P<0.001) and 12 months (ρ=-0.21, P<0.001).

Conclusions : DED symptoms and signs were worse in moderate to severe DED patients screening positive for depression. However, depression was more strongly associated with severity of the symptoms than clinical signs of DED, which may relate to the discordance between symptoms and signs of DED.

This is a 2021 ARVO Annual Meeting abstract.

 

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