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Janika Nättinen, Ulla Aapola, Jaakko Tuomilehto, Sirkka Keinänen-Kiukaanniemi, Jouko Saramies, Hannu Uusitalo; Ocular surface characteristics in Finnish elderly population. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1263.
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© ARVO (1962-2015); The Authors (2016-present)
The prevalence of many ocular surface diseases (OSDs) increases with age, which together with population ageing, create a need for better understanding of OSD among the elderly. The aim of this study was to describe the clinical characteristics of OSD in a well-defined Finnish elderly population.
This cross-sectional study included subjects born between years 1933-1956 and living in Savitaipale, Finland. Various ocular surface health parameters were evaluated, including Schirmer’s I test, fluorescein tear break-up time (FTBUT), corneal and conjunctival staining, conjunctival redness, blepharitis, Meibomian gland dysfunction (MGD) and Ocular Surface Disease Index (OSDI). The prevalence of various forms dry eye (DE) and their clinical characteristics were evaluated based on adjusting different OSD criteria and comparing them statistically using Wilcoxon rank sum test and two-sample t-test.
The study included 590 subjects (328 women and 262 men), with mean age of 72.1 years (SD=6.3). Lid and tear lipid dysregulation characteristics were following; 16% of subjects had signs of blepharitis (Efron scale≥2), 15% had signs of MGD (Efron scale≥2) and 38% had FTBUT below 10 sec. Over half of all subjects (54%) had sings of conjunctival redness (SILK-HU≥2), while conjunctival (Lissamine) staining and corneal (fluorescein) staining showed signs of epithelium damage for 12% and 29% of subjects, respectively (Oxford scale≥I). Altogether 32% of subjects had Schirmer I test below 10 mm indicating lowered tear flow. OSDI scores suggested that 13% of subjects had mild, 6% moderate and 3% severe DE. Prior to the study, DE had been diagnosed for 30% subjects and 36% used a DE medication of some form. Based on the clinical signs observed, 10% of all subjects suffered from DE and 38% from OSD. When aforementioned groups were compared to subjects with healthy ocular surface, conjunctival and corneal staining as well as OSDI were increased (all p<0.001) while FTBUT was decreased (all p<0.001) among all groups.
DE and OSD are common among the old adult population. Their prevalence is, however, strongly dependent on the criteria and cut-off values of independent parameters. Comparison of the patients’ awareness of their disease and the use of artificial tear substitutes with the clinical signs and symptom scores indicates unmet needs for better understanding of factors related to OSD and improved biomarkers in their analyses.
This is a 2021 ARVO Annual Meeting abstract.
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