Shedding light on pharmacoepidemiology of eye diseases: a cohort study in Western Iran

The primary goal in treating glaucoma and other eye disorders is to improve the quality of life for the patient while preserving vision, with minimal side effects. One has to understand the increasing demand for health resources by gaining insight into treatment norms and associated costs. Pharmacoepidemiologic studies examine the use of drugs, their effectiveness, and the safety aspects on large populations by observational studies to realize typical drug effects, adverse reactions, and risk factors. This study fills a gap in areas where little has been done, considering that the vast majority of studies done in this field are based in the US and Europe and only a handful have come from developing countries. The primary aim of this study was to evaluate the pharmacoepidemiology of ophthalmic medications and their association with ocular disease prevalence in a population-based cohort in western Iran. We analyzed the relationship between the pharmacoepidemiology of pharmaceutical medicines and the incidence of associated diseases, while considering significant and extraneous factors influencing disease occurrence. The present study seeks to specifically evaluate the prescribing patterns of the ophthalmic drugs in Kermanshah province. During a 6-year cohort study of 10,046 RaNCD participants, 16.23% used ophthalmic medications, with diabetes, hypertension, cardiovascular disease (CVD), aging, and female sex identified as high-risk factors, whereas normal BMI and regular physical activity were associated with lower prevalence. Dry eye disease (12.19%), allergic conjunctivitis (8.98%), and glaucoma (1.12%) were the most prevalent conditions, showing disparities between genders and across socioeconomic groups. From the perspective of medication, it was dry eye (42.26%, with major use of artificial tears), with many self-stopping (e.g., gentamicin: 38.46%), which points to an asymmetry between adherence and severity management of treatment. The overall eye disease prevalence in males was 26.33% and 34.02% in females, thus pointing to the greater incidence in women who exhibit higher rates for most of the ophthalmopathies, excluding uveitis. The country's prevalence numbers for dry eye disease (DED), allergic conjunctivitis, blepharitis, and glaucoma were quite low compared with the global average, while those for infectious conjunctivitis seem to sit somewhere in between what is seen in developed countries, with uveitis perched above the global average. We also observed an inversely proportional relationship between chronic diseases and eye disorders; diabetes being associated with all the ophthalmic conditions considered except uveitis. In this population, the prevalence of DED, allergic conjunctivitis, blepharitis, and glaucoma was below the global average, while infectious conjunctivitis was similar to its prevalence in developed countries and uveitis exceeded the global average. In addition, we found that there is a reciprocal relationship between chronic diseases and eye disorders, with diabetes being paired with all ophthalmic conditions except uveitis.