Eyeworld

58 | EYEWORLD | DECEMBER 2019 C ORNEA RESEARCH HIGHLIGHT by Vanessa Caceres EyeWorld Contributing Writer Crunching the numbers The overall prevalence of DED was 5.28%. It was higher among females (7.78%) than males (2.96%). Prevalence also increased with age: 0.20%, 2.03%, 5.74%, and 11.66% for age groups 2–17, 18–39, 40–49, and 50+, respec- tively. Using the International Statistical Classifica- tion of Diseases and Related Health Problems, Ninth Revision (ICD-9) and Current Procedural Terminology, the top nondriving and driving factors for dry eye disease included unspecified tear film insufficiency (88.04%), keratocon- junctivitis sicca (10.19%), rheumatoid arthritis (7.98%), and Sjögren's sicca syndrome (6.58%). The annual prevalence of DED increased from 0.83% in 2005 to 3.02% in 2012. Re- searchers also found that dry eye prevalence in- creased in patients under age 50—an age group not typically associated with dry eye. There also was an increase in the annual incidence of dry eye. The increase in annual prevalence may be due to higher education and awareness of DED as a treatable condition, the researchers wrote. "We know that dry eye disease is very prev- alent, and this study clearly confirmed it," Dr. Dana said. Although the study had a large sample of the U.S. population, identifying a condition that may be classified under several codes was a limitation, the researchers wrote. Weighing in Robert Honkanen, MD, said the results confirm trends observed by other researchers and phy- sicians. He said the prevalence of 5.28% seems lower than expected compared to other reports. "Presumably, this difference may be attributable to factors in study design, including incorpora- tion of younger age groups in the study cohort and the strict criteria used as driving factors for DED diagnosis, which might have missed milder forms of the disease," he said, calling the results "likely conservative." Marjan Farid, MD, also said the overall incidence found was lower than anticipated. "It was likely due to less identification in the earlier A study involving the Department of Defense Military Health System found the prevalence and incidence of dry eye disease (DED) increased over time in all demographics. Reza Dana, MD, and coresearch- ers also found that dry eye increased among younger patients, a group not usually associated with dry eye. Researchers used Military Health System claims data from 2003–2015 in the retrospec- tive, company-sponsored study published in the American Journal of Ophthalmology. 1 Data includ- ed DOD service members, retirees, and their dependents. With a common employer, there is less socioeconomic disparity and the sample is geographically and demographically represen- tative of the U.S. population, the researchers wrote. Overall DED prevalence, as well as annual prevalence, annual incidence, and prescriptions for cyclosporine ophthalmic emulsion (Restasis, Allergan) were analyzed. "Because there is no universal diagnosis of DED, and therefore no unique diagnosis code to identify DED specif- ically, the present study used a combination of diagnoses, procedures, and/or prescription fills to identify patients with a high likelihood of having dry eye disease," they wrote. The analysis included 9.7 million beneficia- ries (48% female). Among them, 20.8% were age 2–17, 34.6% were 18–39, 11.15% were 40–49, and 33.4% were 50 or older. Large study tracks dry eye's increasing prevalence and incidence About the doctors Reza Dana, MD Claes H. Dohlman Professor of Ophthalmology Harvard Medical School Boston Marjan Farid, MD Professor of ophthalmology Gavin Herbert Eye Institute University of California, Irvine Irvine, California Robert Honkanen, MD Chair Department of Ophthalmology Stony Brook Medicine Commack, New York Aqueous deficient dry eye disease (lissamine staining of cornea and conjunctiva) Source: Vincent de Luise, MD Contact information Dana: Reza_Dana@meei.harvard.edu Farid: mfarid@uci.edu Honkanen: Kali.Chan@stonybrookmedicine. edu

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