ABSTRACT
ABSTRACT Purpose: To assess Meibomian gland dysfunction using meibography in patients with xeroderma pigmentosum and correlate with ocular surface changes. Methods: This cross-sectional study evaluated patients with xeroderma pigmentosum. All patients underwent a comprehensive and standardized interview. The best-corrected visual acuity of each eye was determined. Detailed ophthalmic examination was conducted, including biomicroscopy examination of the ocular surface, Schirmer test type I, and meibography, and fundus examination was also performed when possible. Meibomian gland dysfunction was assessed by non-contact meibography using Oculus Keratograph® 5M (OCULUS Inc., Arlington, WA, USA). Saliva samples were collected using the Oragene DNA Self-collection kit (DNA Genotek Inc., Ottawa, Canada), and DNA was extracted as recommended by the manufacturer. Factors associated with abnormal meiboscores were assessed using generalized estimating equation models. Results: A total of 42 participants were enrolled, and 27 patients underwent meibography. The meiboscore was abnormal in the upper eyelid in 8 (29.6%) patients and in the lower eyelid in 17 (62.9%). The likelihood of having abnormal meiboscores in the lower eyelid was 16.3 times greater than that in the upper eyelid. In the final multivariate model, age (p=0.001), mutation profile (p=0.006), and presence of ocular surface malignant tumor (OSMT) (p=0.014) remained significant for abnormal meiboscores. For a 1-year increase in age, the likelihood of abnormal meiboscores increased by 12%. Eyes with OSMT were 58.8 times more likely to have abnormal meiboscores than eyes without ocular surface malignant tumor. Conclusion: In the final model, age, xeroderma pigmentosum profile, previous cancer, and clinical alterations on the eyelid correlated with a meiboscore of ≥2. Meibomian gland dysfunction was common in patients with xeroderma pigmentosum, mainly in the lower eyelid. The severity of Meibomian gland dysfunction increases with age and is associated with severe eyelid changes.
ABSTRACT
ABSTRACT Purpose: To estimate the prevalence and risk factors of dry eye disease symptoms and clinical diagnoses in Sao Paulo city, state of Sao Paulo, Brazil. Methods: A total of 582 participants over 18 years old, living in the east zone of Sao Paulo city responded to a short questionnaire. Dry eye disease was on that is defined by the presence of severe symptoms or previous clinical diagnosis of dry eye disease by an ophthalmologist. The association between dry eye disease and possible risk factors was assessed. Results: Overall dry eye disease severe symptoms and/or clinical diagnoses prevalence was calculated as 24.4% for both sexes. Women presented a higher frequency of severe symptoms of dry eye disease (16.07%) than men (8.48%; p=0.0244), as well as the composite of severe symptoms or diagnosed dry eye disease, presented by 26.86% of women and 18.18% of men (p=0.0366). In women, ages between 55 to 75 years old were associated with dry eye disease severe symptoms (OR=3.11; 95%CI 1.56-6.23, p=0.001) and diagnosed dry eye disease (OR=2.02; 95% CI 1.04-3.93, p=0.037). Hypertension was significantly associated with dry eye disease symptoms (OR=1.98; 95% CI 1.14-3.43, p=0.015) and diagnoses (OR=3.54; 95% CI 1.92-6.53, p=0.0001) in women. Eye drops use was associated with severe symptoms of dry eye disease and diagnosed dry eye disease in both women and men (p≤0.01). Conclusions: Dry eye disease prevalence in Sao Paulo city is higher in women than in men. Age and hypertension were stronger risk factors of dry eye disease for women, while eye drops use was a significant indicator of dry eye disease for both sexes.
RESUMO Objetivo Estimar a prevalência e os fatores de risco para os sintomas e o diagnóstico clínico da doença do olho seco na cidade de São Paulo, estado de São Paulo, Brasil. Métodos: Quinhentos e oitenta e dois participantes acima de 18 anos, residentes na zona leste da cidade de São Paulo responderam a um questionário de três perguntas sobre olho seco. A doença do olho seco foi definida pela presença de sintomas severos ou diagnóstico clínico prévio de doença do olho seco por um oftalmologista. A associação entre doença do olho seco e possíveis fatores de risco foi avaliada. Resultados: A prevalência de sintomas graves da doença do olho seco e/ou diagnóstico clínico foi calculada em 24,4% para ambos os sexos. O sexo feminino apresentou uma frequência maior de sintomas severos da doença do olho seco (16,07%) que o sexo masculino (8,48%; p=0,0244), assim como a associação de sintomas severos ou diagnóstico de doença do olho seco, foi de 26,86% no sexo feminino e 18,18% no sexo masculino (p=0,0366). No sexo feminino, a faixa etária entre 55 e 75 anos de idade foi associada com sintomas severos da DOS (odds ratios (OR) = 3,11; IC 95% 1,56-6,23; p=0,001) e com doença do olho seco diagnosticada (OR=2,02; IC 95% 1,04-3,93; p=0,037). Hipertensão foi associado com sintomas da doença do olho seco (OR=1,98; IC 95% 1,14-3,43; p=0,015) e diagnóstico da doença do olho seco (OR=3,54; IC 95% 1,92-6,53; p=0,001) no sexo feminino. Uso de colírios foi associado a sintomas severos e diagnóstico da doença do olho seco em ambos os sexos (p≤0,01). Conclusão: A prevalência da doença do olho seco na cidade de São Paulo é mais frequente no sexo feminino que no masculino. Idade e hipertensão foram fatores de risco maiores para doença do olho seco no sexo feminino, enquanto uso de colírios foi um indicador de doença do olho seco para ambos os sexos.