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Classification of dry eye disease subtypes
M Vidal-Rohr1, J P Craig2, L N Davies1
1School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK.
Summary
This study established new clinical criteria for classifying dry eye disease (DED) subtypes. Evaporative DED (EDE) is most prevalent, while aqueous-deficient DED (ADDE) is less common in the UK population.
Area of Science:
- Ophthalmology
- Dry Eye Disease Research
- Clinical Epidemiology
Background:
- Current dry eye disease (DED) subclassifications (aqueous deficient - ADDE, evaporative - EDE) lack consistent clinical definitions.
- This inconsistency hinders epidemiological studies of DED subtypes.
Purpose of the Study:
- To establish data-driven cut-off values for subclassifying ADDE and EDE.
- To enable more consistent epidemiological studies of DED subtypes.
Main Methods:
- Enrolled 261 UK residents representative of the general population.
- Utilized TFOS DEWS II criteria for DED diagnosis.
- Measured meibomian gland loss, lipid layer thickness (LLT), tear meniscus height (TMH), and tear evaporation to characterize subtypes.
Main Results:
- Evaporative DED (EDE) characterized by meibomian gland loss >28%, LLT <3, and evaporation >46 g/m²/h.
- Aqueous-deficient DED (ADDE) characterized by TMH <0.2 mm.
- Prevalence: ADDE 6.2%, EDE 64.2%, both 11.1%, unclassified 18.5%. Contact lens wear and computer use linked to ADDE; age linked to EDE.
Conclusions:
- Data-driven classification confirms EDE as the most prevalent DED subtype.
- In a generalizable UK population, ADDE alone accounts for approximately 1 in 16 DED cases.
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