Abstract
Purpose :
Severe dry eye disease (DED) is associated with increased prevalence of depression. In this study, patient experiences with depression, systemic disease and dry eye symptoms are described.
Methods :
An electronic survey was designed in REDCap (Research Electronic Data Capture) and approved by the University of Illinois at Chicago IRB. A link to the survey was provided to foundations and support organizations for conditions commonly associated with DED for distribution to their members. Individuals were asked if they had been diagnosed with DED, to identify all existing systemic disease(s), and whether they had been formally diagnosed with depression. The PHQ-2 depression screen (score 3 or higher indicates major depression is likely) and the Ocular Surface Disease Index (OSDI) (score over 33 indicates severe dry eye) were included in the questionnaire. Descriptive statistics are reported.
Results :
There were 639 individuals that completed the survey with DED and an average age of 54 ± 14 years (n= 595, range 18 to 89 years; 90 males, 535 females). Average years since DED diagnosis was 11 ± 10 years (n=627). 21% (132/639) reported a diagnosis of depression, while 27% (163/606) had a positive PHQ-2 screening. Average OSDI score was 51 ± 23 (n=617).
There were 142 participants with no reported systemic disease or depression. Reported systemic disease in the population was distributed as follows: 242 Sjogren’s disease, 129 Thyroid disease, 79 Graft vs Host Disease (GVHD), 59 Rosacea, 46 Rheumatoid Arthritis (RA), 43 Scleroderma and 41 Steven Johnson’s syndrome (SJS). The percentage of respondents with reported depression varied by comorbid condition, from 22% (GVHD n=79 and SJS n=41) to 37% (thyroid n=129 and RA n=44). OSDI scores for all groups ranged from 51 ± 25 (no systemic co-morbidity, n=120) to 58 ± 24 (SJS, n=41). Percentages of patients for whom the PFQ-2 was greater than 3 also differed by systemic disease; scleroderma was the least 14% (6/43), the rest ranged from 20 % in RA (9/46) to 34% in rosacea (20/59).
Conclusions :
This cohort of individuals with DED and co-morbid systemic conditions reported high rates of depression. 26% of participants with DED and at least one co-morbid systemic condition reported depression, higher than many reported studies. Practitioners should be aware of the high risk of depression in patients with DED and provide mental health resources.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.