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International Ophthalmology

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01-12-2024 | Xerophthalmia | Original Paper

Is there a relationship between the severity of disease in major depressive disorder patients and dry eye disease?

Authors: Gizem Doğan Gökçe, Merve Metin

Published in: International Ophthalmology | Issue 1/2024

Abstract

Purpose

To investigate dry eye disease (DED) in newly diagnosed patients with depressive disorder (MDD).

Method

This observational study included 48 MDD patients in Group 1 and 20 healthy controls in Group 2. Psychiatric and ophthalmic examinations, Beck Depression Inventory (BDI), Ocular Surface Disease Index (OSDI), Schirmer's test, tear breakup time (TBUT), Meibomian gland dysfunction (MGD), and ocular staining were conducted. The results were statistically compared.

Results

The participants, comprising 32 men and 36 women, had a mean age of 31.08 ± 11.7 years (18–64 years). Group 1 had a mean BDI score of 30.87 ± 8.56, while Group 2 had a score of 1.3 ± 1.3 (p < 0.001). In Group 1, 28 patients were diagnosed with DED, whereas in Group 2, six subjects were diagnosed with DED. The mean Schirmer's results in Group 1 and Group 2 were (mm/5 min) 10.87 ± 2.44 and 12.70 ± 2.3, respectively, and were significantly lower in Group 1 (p < 0.001). The mean OSDI scores in Group 1 (34.95 ± 15.8) were significantly higher compared to Group 2 (3.2 ± 3.1) (p < 0.001). There was no significant difference in mean TBUT between Group 1 (9.41 ± 2.6 s) and Group 2 (9.8 ± 0.61 s) (p > 0.05). Significant correlations were found between BDI scores and Schirmer's results as well as OSDI scores (p < 0.05, p = 0.02, respectively). No statistically significant correlations were found between BDI scores and TBUT or MGD (p > 0.05).

Conclusion

DED was found to be more prevalent in the MDD group. The severity of MDD and DED, as indicated by BDI, OSDI, and Schirmer's results, was found to be correlated. It was observed that patients with higher depression scores had more severe dry eye. As a result, we recommend performing ophthalmic examinations in newly diagnosed MDD patients.

Messmer EM (2015) The pathophysiology, diagnosis, and treatment of dry eye disease. Deutsches Ärzteblatt Int 112(5):71. https://doi.org/10.3238/arztebl.2015.0071CrossRef

Shen Lee B, Kabat AG, Bacharach J, Karpecki P, Luchs J (2020) Managing dry eye disease and facilitating realistic patient expectations: a review and appraisal of current therapies. Clin Ophthalmol 14(14):119–126. https://doi.org/10.2147/OPTH.S228838.PMID:32021076;PMCID:PMC6969676CrossRefPubMedPubMedCentral

Elhusseiny AM, Khalil AA, El Sheikh RH, Bakr MA, Eissa MG, El Sayed YM (2019) New approaches for diagnosis of dry eye disease. Int J Ophthalmol 12(10):1618–1628. https://doi.org/10.18240/ijo.2019.10.15.PMID:31637199;PMCID:PMC6796083CrossRefPubMedPubMedCentral

Stapleton F, Alves M, Bunya VY, Jalbert I, Lekhanont K, Malet F, Na KS, Schaumberg D, Uchino M, Vehof J, Viso E, Vitale S, Jones L (2017) TFOS DEWS II epidemiology report. Ocul Surf 15(3):334–365. https://doi.org/10.1016/j.jtos.2017.05.003. (Epub 2017 Jul 20 PMID: 28736337)CrossRefPubMed

World Health Organization. Depression (2021) https://www.who.int/news-room/fact-sheets/ detail/depression

Bains N, Abdijadid S (2023) Major depressive disorder. 2023 Apr 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, PMID: 32644504

Hallak JA, Tibrewal S, Jain S (2015) Depressive symptoms in patients with dry eye disease: a case-control study using the beck depression inventory. Cornea 34(12):1545–1550. https://doi.org/10.1097/ICO.0000000000000641.PMID:26426334;PMCID:PMC4636920CrossRefPubMedPubMedCentral

Toth M, Jokić-Begić N (2020) Psychological contribution to understanding the nature of dry eye disease: a cross-sectional study of anxiety sensitivity and dry eyes. Health Psychol Behav Med 8(1):202–219. https://doi.org/10.1080/21642850.2020.1770093.PMID:34040868;PMCID:PMC8114394CrossRefPubMedPubMedCentral

Kaštelan S, Bakija I, Bogadi M, Orešković I, Kasun B, Gotovac M, Gverović Antunica A (2021) Psychiatric disorders and dry eye disease—a transdisciplinary approach. Psychiatr Danub 33(suppl 4):580–587PubMed

10.

Han SB, Yang HK, Hyon JY, Wee WR (2017) Association of dry eye disease with psychiatric or neurological disorders in elderly patients. Clin Interv Aging 15(12):785–792. https://doi.org/10.2147/CIA.S137580.PMID:28553087;PMCID:PMC5439727CrossRef

11.

Basilious A, Xu CY, Malvankar-Mehta MS (2022) Dry eye disease and psychiatric disorders: a systematic review and meta-analysis. Eur J Ophthalmol 32(4):1872–1889CrossRefPubMed

12.

Kim KW, Han SB, Han ER, Woo SJ, Lee JJ, Yoon JC, Hyon JY (2011) Association between depression and dry eye disease in an elderly population. Invest Ophthalmol Vis Sci 52(11):7954–7958. https://doi.org/10.1167/iovs.11-8050. (PMID: 21896858)CrossRefPubMed

13.

Wen W, Wu Y, Chen Y, Gong L, Li M, Chen X, Yan M, Xiao Z, Sun X (2012) Dry eye disease in patients with depressive and anxiety disorders in Shanghai. Cornea 31(6):686–692. https://doi.org/10.1097/ICO.0b013e3182261590. (PMID: 22382595)CrossRefPubMed

14.

Koçer E, Koçer A, Özsütçü M, Dursun AE, Krpnar İ (2015) Dry eye related to commonly used new antidepressants. J Clin Psychopharmacol 35(4):411–413. https://doi.org/10.1097/JCP.0000000000000356. (PMID: 26075491)CrossRefPubMed

15.

Mrugacz M, Ostrowska L, Bryl A, Szulc A, Zelazowska-Rutkowska B, Mrugacz G (2017) Pro-inflammatory cytokines associated with clinical severity of dry eye disease of patients with depression. Adv Med Sci 62(2):338–344. https://doi.org/10.1016/j.advms.2017.03.003. (Epub 2017 May 13 PMID: 28511072)CrossRefPubMed

16.

Richter P, Werner J, Heerlein A, Kraus A, Sauer H (1998) On the validity of the beck depression inventory. A Rev Psychopathol 31(3):160–168. https://doi.org/10.1159/000066239. (PMID: 9636945)CrossRef

17.

At B (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571CrossRef

18.

Beck AT, Epstein N, Brown G, Steer RA (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56(6):893–897. https://doi.org/10.1037//0022-006x.56.6.893. (PMID: 3204199)CrossRefPubMed

19.

Ponzini E, Scotti L, Grandori R, Tavazzi S, Zambon A (2020) Lactoferrin concentration in human tears and ocular diseases: a meta-analysis. Invest Ophthalmol Vis Sci 61(12):9. https://doi.org/10.1167/iovs.61.12.9.PMID:33035290;PMCID:PMC7552940CrossRefPubMedPubMedCentral

20.

Abelson MB, Ousler GW 3rd, Nally LA, Welch D, Krenzer K (2002) Alternative reference values for tear film break up time in normal and dry eye populations. Adv Exp Med Biol 506(Pt B):1121–1125. https://doi.org/10.1007/978-1-4615-0717-8_157. (PMID: 12614039)CrossRefPubMed

21.

Bron AJ, Evans VE, Smith JA (2003) Grading of corneal and conjunctival staining in the context of other dry eye tests. Cornea 22(7):640–650. https://doi.org/10.1097/00003226-200310000-00008CrossRefPubMed

22.

Bron AJ, Benjamin L, Bilaniuk LT (1991) Meibomian gland disease. Classification and grading of lid changes. Eye 5(4):395–411. https://doi.org/10.1038/eye.1991.65CrossRefPubMed

23.

Mengher LS, Pandher KS, Bron AJ (1986) Non-invasive tear film break-up time: sensitivity and specificity. Acta Ophthalmol (Copenh) 64(4):441–444. https://doi.org/10.1111/j.1755-3768.1986.tb06950.x. (PMID: 3776509)CrossRefPubMed

24.

Lin PY, Tsai SY, Cheng CY, Liu JH, Chou P, Hsu WM (2003) Prevalence of dry eye among an elderly Chinese population in Taiwan: the Shihpai eye study. Ophthalmology 110(6):1096–1101. https://doi.org/10.1016/S0161-6420(03)00262-8. (PMID: 12799232)CrossRefPubMed

25.

Wolffsohn JS, Arita R, Chalmers R, Djalilian A, Dogru M, Dumbleton K, Gupta PK, Karpecki P, Lazreg S, Pult H, Sullivan BD, Tomlinson A, Tong L, Villani E, Yoon KC, Jones L, Craig JP (2017) TFOS DEWS II diagnostic methodology report. Ocul Surf 15(3):539–574. https://doi.org/10.1016/j.jtos.2017.05.001. (Epub 2017 Jul 20 PMID: 28736342)CrossRefPubMed

26.

Özcura F, Aydin S, Helvaci M (2007) Ocular surface disease index for the diagnosis of dry eye syndrome. Ocul Immunol Inflamm 15:389–393. https://doi.org/10.1080/09273940701486803CrossRefPubMed

27.

Dry Eye Workshop (DEWS) (2007) The definition and classification of dry eye disease: report of the definition and classification subcommittee of the international dry eye workshop. Ocul Surf 5(2):75–92. https://doi.org/10.1016/s1542-0124(12)70081-2CrossRef

28.

Weatherby TJM, Raman VRV, Agius M (2019) Depression and dry eye disease: a need for an interdisciplinary approach? Psychiatr Danub 31(Suppl 3):619–621 (PMID: 31488802)PubMed

29.

Kitazawa M, Sakamoto C, Yoshimura M, Kawashima M, Inoue S, Mimura M, Tsubota K, Negishi K, Kishimoto T (2018 Dec 28) The Relationship of Dry Eye Disease with Depression and Anxiety: A Naturalistic Observational Study. Transl Vis Sci Technol. 7(6):35. https://doi.org/10.1167/tvst.7.6.35CrossRefPubMedPubMedCentral

30.

Tiskaoglu NS, Yazıcı A, Karlıdere T, Sari E, Oguz EY, Musaoglu M, Aslan S, Samet ES (2017) Dry eye disease in patients with newly diagnosed depressive disorder. Curr Eye Res 42(5):672–676. https://doi.org/10.1080/02713683.2016.1236966. (Epub 2016 Nov 21 PMID: 27870590)CrossRefPubMed

31.

Rodríguez-Aguayo AM, Martínez-Lavin M, Martínez-Martínez LA (2021) Correlation between corneal nerve density and symptoms of small fiber neuropathy in patients with fibromyalgia: the confounding role of severe anxiety or depression. J Clin Rheumatol 27(8):e606–e608. https://doi.org/10.1097/RHU.0000000000001592. (PMID: 33044388)CrossRefPubMed

32.

Leonardi A, Feuerman OM, Salami E, Lazzarini D, Cavarzeran F, Freo U, Maggioni F (2023) Coexistence of neuropathic corneal pain, corneal nerve abnormalities, depression, and low quality of life. Eye, 1-8. https://doi.org/10.1038/s41433-023-02710-w. Epub ahead of print. PMID: 37620513.

33.

Ulusoy MO, Işık-Ulusoy S, Kıvanç SA (2019) Evaluation of dry eye disease in newly diagnosed anxiety and depression patients using anterior segment optical coherence tomography. Eye Vis (Lond) 9(6):25. https://doi.org/10.1186/s40662-019-0149-y.PMID:31417939;PMCID:PMC6688380CrossRef

34.

Dibajnia P, Mohammadinia M, Moghadasin M, Amiri MA (2012) Tear film break-up time in bipolar disorder. Iran J Psychiatry 7(4):191PubMedPubMedCentral

35.

Labbé A, Wang YX, Jie Y, Baudouin C, Jonas JB, Xu L (2013) Dry eye disease, dry eye symptoms and depression: the Beijing eye study. Br J Ophthalmol 97(11):1399–1403. https://doi.org/10.1136/bjophthalmol-2013-303838. (Epub 2013 Sep 7 PMID: 24013959)CrossRefPubMed

36.

Bitar MS, Olson DJ, Li M, Davis RM (2019) The correlation between dry eyes, anxiety and depression: the sicca. Anxiety Depress Study Cornea 38(6):684–689. https://doi.org/10.1097/ICO.0000000000001932. (PMID: 30950896)CrossRef

37.

Zhou Y, Murrough J, Yu Y, Roy N, Sayegh R, Asbell P, DREAM Study Research Group (2022) Association between depression and severity of dry eye symptoms, signs, and inflammatory markers in the DREAM study. JAMA Ophthalmol 140(4):392–399. https://doi.org/10.1001/jamaophthalmol.2022.0140.PMID:35266971;PMCID:PMC8914873CrossRefPubMedPubMedCentral

38.

Constable PA, Al-Dasooqi D, Bruce R, Prem-Senthil M (2022) A review of ocular complications associated with medications used for anxiety, depression, and stress. Clin Optom (Auckl) 24(14):13–25. https://doi.org/10.2147/OPTO.S355091.PMID:35237084;PMCID:PMC8884704CrossRef

39.

Lim MN, Lee JY, Hyon JY, Han SB (2023) Association of self-reported psychiatric and systemic risk factors in dry eye disease in adult Korean population. Eye (Lond). https://doi.org/10.1038/s41433-023-02803-6. Epub ahead of print. PMID: 37898716

40.

Chhadva P, Lee T, Sarantopoulos CD, Hackam AS, McClellan AL, Felix ER, Galor A (2015) Human tear serotonin levels correlate with symptoms and signs of dry eye. Ophthalmology 122(8):1675–1680CrossRefPubMed

Title: Is there a relationship between the severity of disease in major depressive disorder patients and dry eye disease?
Authors: Gizem Doğan Gökçe
Merve Metin
Publication date: 01-12-2024
Publisher: Springer Netherlands
Keywords: Xerophthalmia
Mood Disorders
Affective Disorder
Published in: International Ophthalmology / Issue 1/2024
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-024-03050-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Is there a relationship between the severity of disease in major depressive disorder patients and dry eye disease?

Abstract

Purpose

Method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Method

Results

Conclusion

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