Abstract
Purpose :
Some systemic medications are reported to be associated with occurrence of dry eye disease (DED), yet their associations with the severity of DED are not well studied. We evaluated whether classes of systemic medications are associated with the severity of DED signs and symptoms via secondary analysis of data from the Dry Eye Assessment and Management (DREAM) study, a large multi-center randomized placebo-controlled clinical trial of patients with moderate-to-severe DED.
Methods :
At baseline, 535 patients with moderate-to-severe DED self-reported their current use of systemic medications. At baseline, 6 and 12 month timepoints, DED symptoms were assessed using the Ocular Surface Disease Index (OSDI) and DED signs in each eye were evaluated: tear break up time (TBUT), Schirmer’s test, corneal fluorescein staining, conjunctival lissamine green staining, Meibomian gland dysfunction and tear osmolarity. Systemic medications were categorized into the following classes: statin, proton pump inhibitor (PPI), aspirin, vitamin D3, nonsteroidal anti-inflammatory drugs (NSAID), steroids, diuretics, and medications for treating hypothyroidism, diabetes mellitus, hypertension, seizure, and migraine. Generalized linear models were used to compare the scores of DED symptoms and signs (at all three timepoints combined) between users and non-users for each of these medication classes, with adjustment factors that were previously found to be associated with severity of DED in the DREAM study.
Results :
As shown in Table 1, compared to non-users, aspirin users had lower TBUT; steroid users had lower TBUT, lower Schirmer test scores, and higher tear osmolarity; seizure medication users had had higher composite dry eye severity score; vitamin D3 users had lower TBUT and greater Meibomian gland abnormality; users of medications for migraine had lower Schirmer test scores; and diuretic users had less Meibomian gland abnormality. None of the systemic medications was associated with the severity of symptoms (Table 2).
Conclusions :
Use of aspirin, steroids, vitamin D3, and medications for seizure and migraine was associated with worse DED severity, while the use of diuretics was associated with less Meibomian gland abnormality. No systemic medications were associated with DED symptom severity.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.