The Association between Symptoms of Dry Eye Syndrome and Metabolic Outcome in a General Population in Korea

Link Between Metabolic Syndrome, Inflammation, and Eye Diseases

Metabolic syndrome (MetS)-a cluster of conditions including obesity, hypertension, dyslipidemia, and insulin resistance-is increasingly recognized as a key risk factor for the development of various eye diseases. The metabolic dysfunctions associated with this syndrome contribute to vascular and neurodegenerative damage within the eye, influencing disease onset and progression. Understanding these links highlights the importance of early diagnosis and management of metabolic syndrome to prevent vision loss and improve ocular health outcomes. This review explores the intricate interplay between metabolic syndrome, chronic low-grade inflammation, and eye diseases such as diabetic retinopathy, age-related macular degeneration, glaucoma, and dry eye syndrome. It highlights how inflammatory mediators, oxidative damage, and metabolic dysregulation converge to compromise ocular structures, including the retina, optic nerve, and ocular surface. We discuss the molecular and cellular mechanisms underpinning these associations and examine evidence from clinical and experimental studies. Given the rising global prevalence of metabolic syndrome, addressing this connection is crucial for improving overall patient outcomes and quality of life. Future research should focus on delineating the precise mechanisms linking these diseases as well as exploring targeted interventions that address both metabolic and ocular health.

Prevalence of dry eye in Brazil: Home survey reveals differences in urban and rural regions

PURPOSE

A random home visit search investigated the prevalence and predictors of Dry Eye (DE) symptoms in Brazil.

METHODS

Through home visits to 420 urban and 180 rural residences in the countryside of Southeast Brazil, the Dry Eye Disease Short Questionnaire (DEDSQ) was applied to volunteers 40 years and older. The predictive value of the DEDSQ and the risk factors were investigated.

RESULTS

DE is more frequent in the urban population (38.1 % vs. 20 %; p < 0.0001) and was higher in females (37.5 % and 21.5 %; p < 0.0001). In the urban area, DE is associated with dyslipidemia (p < 0.0001), visual display terminal use > 2 h/day (p < 0.0001), and pterygium (p < 0.001), and in the rural area with dyslipidemia (p < 0.01) and prior ocular surgery (p < 0.05). In women, the predictors are antiallergics, chronic pelvic pain, fibromyalgia, and visual display terminal use > 2h/day. Aging was associated with distinct risk factors. DEDSQ showed 78.5 % of sensitivity and 71.1 % specificity.

CONCLUSION

This first domiciliary study in Brazil reveals that DE symptoms were more prevalent in the urban area and among women. DE has distinct risk factors and a high prevalence in Brazil.

Relationship between Dry Eye Disease and Dyslipidemia: A Systematic Review

BACKGROUND

Dyslipidemia has been suggested to be associated with the occurrence of dry eye disease (DED). However, whether dyslipidemia is responsible for the development of DED remains unclear. In this systematic review, we explored the relationship between DED and dyslipidemia by using quantitative data.

METHODS

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a comprehensive literature search in several databases, including PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar, and obtained six relevant studies.

RESULTS

Our findings indicated that the majority of the selected studies reported a statistically significant association between dyslipidemia and DED, particularly in women. However, our quantitative analysis revealed that only two studies reported statistically significant differences in total cholesterol and high-density lipoprotein cholesterol values.

CONCLUSION

No statistically significant differences exist in the majority of lipid profile parameters between individuals with and without DED, but there is a statistically significant association between dyslipidemia and DED.

Dry eye and percentage of body fat: a cross-sectional prospective study

BACKGROUND

Dry eyes are common in the general population. Some studies associate high prevalence of dry eyes with lipid metabolic changes and body fat composition.

AIM

To study the association of dry eye with percentage of body fat.

METHODS

One hundred and thirty five individuals (44 males and 91 females; median age of 42 years) were studied in a cross-sectional prospective study. Schirmer test and TBUT (tear breakup time) test were used to access dry eye. Body composition (percentage of lean and fat mass) were calculated using anthropometric measurements that included height, weight, abdominal, waist and neck circumference.

RESULTS

About 44.4% of the sample had abnormal Schirmer test, and 70.3% had abnormal TBUT. Schirmer tests values were associated with age (p = 0.0006) female gender (p = 0.04) and percentage of body fat (p = 0.02). Abnormal TBUT test associated only with age (p = 0.0005).

CONCLUSIONS

Percentage of body fat is associated with abnormal Schirmer but not TBUT test.

Ocular findings in metabolic syndrome: a review

Metabolic syndrome (MetS) has emerged as a worldwide health hazard of the modern lifestyle, representing a cluster of metabolic abnormalities and a risk factor for cardiovascular disease. Eye diseases, such as diabetic retinopathy, central retinal artery occlusion, cataract, age-related macular degeneration, glaucoma, and dry eye syndrome have been linked with many of MetS components. Their relationship with MetS itself is, however, a recent topic of investigation. This review aims to gather published evidence supporting associations between ocular findings and MetS and to explore the related physiopathological processes that congregate in this syndrome and lead to these diseases. Despite compiling interesting and compelling evidence, it raises awareness to the need of further studies in this field to keep solidifying these associations and unveiling the pathological processes that support them. It ultimately targets MetS patients as a population of individuals who are at increased risk of developing age-related eye diseases and vision loss.

Dry eye disease in patients with metabolic syndrome

OBJECTIVES

To evaluate dry eye disease (DED) in patients with metabolic syndrome (MetS) and compare with healthy individuals.

METHODS

The study was conducted in the Ophthalmology and Endocrinology Department of Bagcilar Education and Research Hospital, a tertiary care center in Istanbul, Turkey, between January and December 2015. In this prospective case-controlled study, dry eye disease tests were performed on 44 patients with MetS and 43 healthy controls. TearLab Osmolarity System, which is a lab-on-a-chip technology, was used to measure tear osmolarity. McMonnies & Ho symptoms questionnaire along with Schirmer I test and tear film break-up time (TFBUT) test were also performed. Statistical evaluation was performed by students' independent test.

RESULTS

There was no statistically significant difference in tear osmolarity, TFBUT, and McMonnies and Ho questionnaire scores between MetS and normal group. However, Schirmer I test was significantly higher in MetS group (14.8±9.4mm versus 20.4±9.4, p=0.007). In women subgroup, tear osmolarity was significantly higher in MetS group compared  to the normal group and over the cut-off score 308 mOsm/L (309.4±13.1 mOsm/L versus 301.2±8.7mOsm/L, p=0.012).

CONCLUSION

Patients with MetS present with lower tear volumes and a higher incidence of lacrimal gland hypofunction than age-matched controls. Especially women with MetS have higher tear osmolarities, which disrupt the normal functioning of the ocular surface and cause inflammation. Clinicians should be aware of higher DED incidence in patients with MetS for early treatment to prevent serious ocular complications.