Eyeworld

52 | EYEWORLD | MAY 2019 C ORNEA RESEARCH HIGHLIGHT Contact information Akpek: esakpek@jhmi.edu Ford: karensuedennis@gmail.com Wang: wangyandoc@163.com by Vanessa Caceres EyeWorld Contributing Writer dryness, foreign body sensation, and tired eyes. Researchers assessed sleep quality with a Chi- nese version of the Pittsburgh Sleep Quality In- dex (PSQI). Mood disorders were analyzed with the Patient Health Questionnaire for depression and with the Generalized Anxiety Disorder Scale for anxiety, both of which contain self-re- ported measures. The mean age in the DED group was 46.52 years, compared with 43.1 years in the control group. Eighty-five percent of DED patients were female, compared with 38% in the control group. Taking a closer look Patients in the DED group had a significantly higher mean PSQI global score. "According to a cutoff point for the PSQI global score that defined a poor sleeper, approximately 68% of patients with DED had poor sleep quality compared with only 40% of the control group (P=0.001)," the researchers wrote. Those with DED also graded their sleep quality more poorly than the controls. Those in the DED group had a shorter mean sleep duration and had more sleep disturbances and daytime dysfunction. Also in the DED group, 46% and 39% could be considered depressive and anxious, compared with only 15% and 13%, respectively, in the control group. When focusing on sleep quality in DED pa- tients, dry eye symptom severity and meibomian gland assessment did not differ significantly between the two subgroups. However, DED patients with poor sleep quality had shorter TBUT and lower Schirmer I test scores. A significant correlation was found between sleep quality and mood status. Dry eye symp- tom severity was associated with anxiety and not any other clinical parameter of DED. Sleeping on it One point the researchers made was that sleep quality is typically affected in older patients, re- gardless of their dry eye status. However, even when including age in the regression models of readjustment, they found that TBUT and A study 1 published in Cornea concluded that sleep quality may play a role in the development of dry eye disease (DED), and it may indirectly aggra- vate anxiety and depression. Mengliang Wu, MD, and fellow researchers cited other recent studies that found worse sleep quality or shorter sleep durations in DED patients. However, the re- searchers also noted a lack of controlled studies that analyze the association between sleep quali- ty and dry eye symptoms. They pointed out that there's interaction between mood status and sleep quality. "The association between DED and sleep quality will remain unclear if no ad- justment is made for mood status," they wrote. In their study, researchers compared sleep quality and mood status in patients with DED against a control group and analyzed differ- ences in dry eye parameters in good and poor sleepers. The researcher included a total of 106 patients examined in the study. They were compared with 50 healthy subjects who did not report any ocular surface discomfort in the previous 2 months. Patients with systemic diseases that can affect the ocular surface and/ or sleep, such as diabetes mellitus, sleep apnea, and autoimmune disease, were excluded. Dry eye-related symptoms, a positive corne- al staining with fluorescein, and a Schirmer I test result of less than 5 mm or a tear breakup time (TBUT) of less than 5 seconds were used to define dry eye. The most common dry eye symptoms reported by study participants were Study links dry eye to poor sleep quality and anxiety, depression About the doctors Esen Akpek, MD The Bendann Family Professor of Ophthalmology and Rheumatology Wilmer Eye Institute at Johns Hopkins Baltimore Francesann Ford, MD, MBA Clinical and surgical director Beautiful Vision Coral Springs, Florida Yan Wang, MD Department of Ophthalmology Eye and ENT Hospital of Fudan University Shanghai, China Reference 1. Wu M, et al. Association be- tween sleep quality, mood status, and ocular surface characteristics in patients with dry eye disease. Cornea. 2019;38:311–317. Financial interests Akpek: None Ford: None Wang: None

• Blank Page
• Blank Page (1)
• Blank Page (2)