Comparison between Neuropathic Corneal Pain and Dry Eye Disease in regards to Age and Gender Dependent Ompairment of Quality-of-Life Dimensions
Leyla Mirzaee, Akhil Mekka, Maria J. Lopez, Navneet Ramesh, Bijan Khaksari, Gabriela M. Dieckmann, Dilruba Koseoglu,
Arsia Jamali, Pedram Hamrah
Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts
Purpose: To compare the perception of ocular discomfort in patients with neuropathic corneal pain (NCP) and dry eye disease (DED), and to measure its impact on physical, psychological, and social quality of life (QoL) dimensions.
Methods: A cross-sectional, retrospective, comparative study was conducted, including NCP (N=119) and DED (N=43) patients. Demographic features, ocular pain assessment survey (OPAS), and ocular surface disease index (OSDI) scores were reviewed, and correlation of ocular discomfort to physical (vision-related), social and psychological dimensions of QoL assessed. The impact of age and gender was evaluated in terms of pain perception and interference on QoL dimensions.
Results: The mean age of DED and NCP were 56.3±15.7 and 56.2±16.0 years, respectively (p=0.966). The mean pain intensity scores (scale 0-10) in the last 24 hours and 2 weeks were 2.04±2.68 in DED patients and 5.03±3.22 in NCP (p<0.01) and 2.08±2.91 (DED) and 4.77±3.51 (NCP; p<0.01) respectively. The interference of pain on QoL (0-10 scale) for DED and NCP patients was: reading/computer (DED 3.33±3.24 vs. NCP 5.54±3.46, p=0.003), driving/TV (DED 3.08±3.28 vs. NCP 4.59±3.32, p= 0.024), Gen Act (DED 2.04±2.77 vs. NCP 3.87±3.04, p=0.001) for the physical (visual related) dimension; Mood (DED 3.04±3.39 vs. NCP 5.66±3.48 p=0.001); sleep (DED 2.32±3.28 vs. NCP 3.46±3.18, p=0.014) for the psychological dimension; and enjoying life/social relations (DED 2.80±3.26 vs. NCP 5.15±3.50, p=0.001) for the social dimension of QoL. The interference of pain was significant for the physical QoL dimension for DED and NCP (R> 0.25; p< 0.05), psychological dimension (mood) in NCP (R= 0.43; p=0.0003), but not in DED (R=0.18; p=0.15), and social dimension (Life/social relations) in NCP (R=0.24; p=0.04), but not in DED (R=0.18; p=0.16). Although age resulted in higher interference of pain in QoL, it did not reach statical significance in either group (p>0.05). Gender did not demonstrate an impact on QoL interference of pain either (p> 0.05).
Conclusions: In patients with NCP, ocular discomfort has a more pronounced interference with physical, psychological, and social dimensions of QoL as compared to patients with DED, regardless of age and sex.
Disclosure: S: NIH-R61NS113341, Tufts Medical Center Institutional Support (Hamrah),
C: Novartis, Dompe, Oysterpoint Pharma (Hamrah)