Study finds association between depression, severe dry eye
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Severe dry eye disease symptoms and signs were found to be associated with depression in a study, suggesting consideration of depression as a possible comorbidity when managing patients with dry eye.
The study was a secondary cross-sectional and longitudinal analysis of data from the Dry Eye Assessment and Management study, which evaluated the efficacy of omega-3 fatty acid supplements vs. placebo. Five hundred thirty-five participants were evaluated for dry eye disease (DED) symptoms and signs, inflammatory markers and depression at baseline, 6 months and 12 months.
Severity of DED symptoms was evaluated by Ocular Surface Disease Index score and Brief Ocular Discomfort Inventory score. Signs of DED were evaluated by corneal fluorescein staining, tear breakup time, Schirmer test, lissamine green staining, tear osmolarity and assessment of meibomian gland dysfunction. Tear samples were collected to evaluate proinflammatory cytokines.
Evaluation of depression was based on the Medical Outcomes Study 36-item Short Form Health Survey, as well as self-reported depression and use of antidepressants.
Patients who screened positive for depression were found to have worse DED signs and symptoms as compared with participants who screened negative for depression. The authors hypothesized that the discomfort and interference with daily activities caused by DED may put patients at a higher risk for depression. In addition, individuals with depression may be more prone to spend time indoors, watching TV or using digital devices, and this may contribute to DED.
“The cause of the observed association needs further investigation,” the authors wrote.
Several tear inflammatory markers implicated in the pathogenesis of both DED and depression were examined, but no correlation was found between cytokine levels and severity of depressive symptoms.
“Identifying depression and considering treatment, including systemic medications, may be useful in managing patients with DED,” the authors wrote. “Patients with more severe DED concerns or sign measurements may benefit from comorbid psychiatric screening.”
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