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Association Between Demyelinating Disease and Dry Eye Syndrome: A Matched Case-Control Study
Kevin T Root1, Lauren Jeang2, Alvaro J Mejía-Vergara2
1College of Medicine, University of Florida Health, Gainesville, FL, USA.
Ophthalmic Epidemiology
|June 30, 2026
Summary
Neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) are linked to dry eye syndrome (DES). This study provides evidence for NMOSD and DES association, urging increased clinical awareness.
Area of Science:
- Neurology
- Ophthalmology
- Immunology
Background:
- Demyelinating diseases, including multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD), have been anecdotally linked to dry eye syndrome (DES).
- Previous studies on this association were limited by small sample sizes and the presence of confounding autoimmune conditions.
- Large-scale epidemiological data specifically linking NMOSD to DES has been lacking.
Purpose of the Study:
- To investigate the association between dry eye syndrome (DES) and demyelinating diseases, specifically MS and NMOSD.
- To leverage a large-scale database to overcome limitations of previous studies.
- To provide epidemiological evidence for the link between NMOSD and DES.
Main Methods:
- A retrospective case-control study using the NIH's All of Us Research Database.
- Patients with DES were identified as cases, and controls were matched by birth year, sex, race, and ethnicity.
- Confounding autoimmune diseases were excluded, and NMOSD was confirmed using aquaporin-4 (AQP4) testing. Analysis adjusted for DES-associated medications.
Main Results:
- A cohort of 25,789 DES cases and 102,954 controls was analyzed after matching.
- Multiple sclerosis (MS) showed a significant association with DES (adjusted OR 1.61).
- Preliminary analysis indicated a significant association between NMOSD and DES (adjusted OR 3.43), though with a modest sample size for NMOSD.
Conclusions:
- Both MS and NMOSD are significantly associated with DES.
- This study presents the first moderate-scale epidemiological evidence linking NMOSD to DES.
- Increased clinical awareness for DES in patients with demyelinating diseases is recommended, with a call for validation in future prospective studies.
