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A descriptive cross-sectional study on the dry eye disease in children in Xiamen, China
Weifang Fang1, Le Sun2, Weiwei Xiong1
1Department of Ophthalmology, Xiamen Children's Hospital (Children's Hospital of Fudan University at Xiamen), Xiamen Key Laboratory of Pediatric General Surgery Diseases, Xiamen, China.
Insights
This study evaluated dry eye disease (DED) questionnaires in children, finding CDEQ and COCI feasible but none distinguished severity. Pediatric-specific tools are needed for accurate DED assessment.
Area of Science:
- Ophthalmology
- Pediatrics
- Clinical Research
Background:
- Dry eye disease (DED) significantly impacts children's quality of life.
- Validated questionnaires are crucial for assessing DED severity and guiding treatment in pediatric populations.
- Existing DED questionnaires may have limitations in pediatric use.
Purpose of the Study:
- To evaluate the clinical characteristics and risk factors of DED in children and adolescents in Xiamen, China.
- To assess the applicability and reliability of three common dry eye disease questionnaires: OSDI, CDEQ, and COCI.
- To provide preliminary descriptive data on the pediatric DED population in the region.
Main Methods:
- A single-center, cross-sectional study involving 105 pediatric patients diagnosed with DED.
- Collected demographic data, clinical findings, risk factors, and scores from OSDI, CDEQ, and COCI questionnaires.
- Analyzed data using univariate analysis, Cronbach's alpha for internal consistency, Spearman correlation for inter-questionnaire relationships, and Kruskal-Wallis/Mann-Whitney U tests for discriminative validity.
Main Results:
- The study included 105 pediatric patients (mean age 7.86 years; 64.76% male), with most being elementary school-aged.
- Meibomian gland dysfunction (MGD) was present in all patients, with 92.38% having mixed-type DED.
- Age, BMI, outdoor activity, and sleep duration were associated with DED subtype or severity. CDEQ and COCI had 100% response rates and acceptable internal consistency, but none of the questionnaires effectively distinguished DED severity.
Conclusions:
- Mixed-type DED with predominant MGD is common in children in Xiamen, associated with factors like obesity and reduced outdoor activity.
- The CDEQ and COCI demonstrated acceptable feasibility and reliability for pediatric DED assessment.
- The OSDI showed limited applicability, and none of the evaluated questionnaires could significantly differentiate DED severity, highlighting the need for pediatric-specific instruments.
Objective:
To evaluate the clinical characteristics, risk factors, and applicability of three commonly used dry eye disease (DED) questionnaires (OSDI, CDEQ, and COCI) in children and adolescents in Xiamen, China, aiming to provide preliminary descriptive data in DED pediatric population.
Methods:
This single-center cross-sectional study included 105 pediatric patients with DED. Demographic data, clinical findings, risk factors, and questionnaire scores were collected. Univariate analysis was used to identify associated factors. Internal consistency was assessed using Cronbach's α, inter-questionnaire correlations using Spearman analysis, and discriminative validity using Kruskal-Wallis and Mann-Whitney U tests.
Results:
Among 105 participants (mean age 7.86 ± 3.13 years; 64.76% male), the majority were elementary school-aged (54.29%). All patients exhibited meibomian gland dysfunction, and 92.38% had mixed-type DED. Age (p = 0.012), BMI (p = 0.067), outdoor activity (p = 0.029), and sleep duration (p = 0.055) were associated with DED subtype or severity. The response rates of the CDEQ and COCI were 100%. All questionnaires showed acceptable internal consistency (Cronbach's α = 0.642-0.919) and moderate correlations. However, none demonstrated significant discriminative ability for DED severity (p > 0.05).
Conclusion:
Given the cross-sectional design, no causal inference can be drawn from these findings. Within this descriptive framework, mixed-type DED with predominant MGD emerged as the main subtype in children in Xiamen. Obesity, limited outdoor activity, and short sleep duration were identified as potential correlates. The CDEQ and COCI showed acceptable feasibility and reliability, while the OSDI demonstrated limited applicability. None of the three questionnaires effectively distinguished severity, underscoring the need for pediatric-specific tools.
