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Dry Eye Syndrome Risks in Patients With Fibromyalgia: A National Retrospective Cohort Study
Chao-Hsien Chen1, Tse-Yen Yang, Cheng-Li Lin
1From the Department of Medical Laboratory Science and Biotechnology (CHC); Molecular and Genomic Epidemiology Center, China Medical University Hospital, China Medical University, Taichung (T-YY); Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua (T-YY); Management Office for Health Data, China Medical University Hospital (C-LL); College of Medicine (C-LL); Division of Chinese Trauma, China Medical University Hospital, China Medical University, Taichung (C-SC); Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi (W-ML); Chang Gung University, Taoyuan (W-ML); Kau-Tang Traditional Medical Hospital, Taichung (C-NK); Department of Nuclear Medicine, E-Da Hospital, I-Shou University, Kaohsiung (M-CL); Department of Nuclear Medicine and PET Center, China Medical University Hospital (C-HK); and Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan (C-HK).
Abstract:
The coexistence of fibromyalgia (FM) and dry eye syndrome (DES) has been previously reported. However, there are few studies on how patients with FM may develop concomitant DES. Patients with chronic widespread pain, like FM, chronic fatigue syndrome, and irritable bowel syndrome (IBS), was concerned for the rheumatic or psychosomatic disorders which might adequately reflect the long-term risk of DES. We retrieved data on FM patients from the National Health Insurance Research Database of Taiwan covering the years 2000 to 2011. Our FM population consisted of 25,777 patients versus 103,108 patients in the non-FM group: the overall incidence of DES in these populations was 7.37/10,000 and 4.81/10,000, respectively. Male FM patients had a higher incidence of DES, with a 1.39-fold DES risk for males and a 1.45-fold for females after adjustment for confounding factor. Notably, FM patients aged ≤49 years had an elevated 80% risk of DES compared with the non-FM group. Without comorbidities, FM patients had an approximately 1.40-fold risk of DES than those without FM. The additive effects of FM and IBS or FM and sleep disturbance were pointed out that the risk for DES would be elevated when the FM patients with IBS or sleep disturbance. FM patients have a higher incidence of DES than that of non-FM patients. They carry long-term DES risks from a relatively young age, particularly those with psychiatric problems. Risk stratification for a timely psychiatric medication intervention and risk modifications are not intended.
Insights
Fibromyalgia (FM) patients have a significantly higher risk of developing dry eye syndrome (DES), especially younger individuals and those with co-occurring conditions like IBS. This highlights a long-term DES risk for FM patients.
Area of Science:
- Rheumatology
- Ophthalmology
- Epidemiology
Background:
- The co-occurrence of fibromyalgia (FM) and dry eye syndrome (DES) is recognized, but the specific pathways and risks for developing DES in FM patients remain under-explored.
- Chronic widespread pain conditions, including FM, chronic fatigue syndrome, and irritable bowel syndrome (IBS), are associated with potential long-term risks for DES.
Purpose of the Study:
- To investigate the incidence and risk of dry eye syndrome (DES) in patients diagnosed with fibromyalgia (FM) compared to a non-FM control group.
- To identify demographic and comorbidity factors influencing DES risk in the FM population.
Main Methods:
- Retrospective cohort study utilizing data from Taiwan's National Health Insurance Research Database (2000-2011).
- Inclusion of 25,777 FM patients and 103,108 non-FM controls.
- Statistical analysis to compare DES incidence rates and calculate adjusted hazard ratios for FM patients, considering age, sex, and comorbidities.
Main Results:
- The overall incidence of DES was higher in the FM group (7.37/10,000) compared to the non-FM group (4.81/10,000).
- FM patients exhibited a 1.40-fold increased risk of DES, even without other comorbidities.
- Elevated DES risk was observed in younger FM patients (≤49 years, 80% increased risk) and was further amplified by the presence of IBS or sleep disturbances.
Conclusions:
- Fibromyalgia patients demonstrate a significantly higher incidence and risk of developing dry eye syndrome.
- The risk of DES in FM patients is present from a younger age and is exacerbated by conditions such as IBS and sleep disturbances.
- These findings suggest a need for increased awareness and potential risk stratification for DES in fibromyalgia patients, particularly those with specific comorbidities.
