Dry Eye 2020

DRY EYE 2020
DED and the
Dunedin Study
By Dr Michael Wang, Dr Graham Wilson and A/Prof Jennifer Craig
THE DUNEDIN MULTIDISCIPLINARY Health and Development
Study (Dunedin Study) is a large longitudinal study investigating human
health, development, ageing and behaviour, which tracks a populationrepresentative
birth cohort born between 1972 and 1973 in Dunedin,
New Zealand.
In the current phase, participants were assessed at the age of 45
and, for the first time, underwent a comprehensive dry eye evaluation.
The reports from the recent global consensus Tear Film and Ocular
Surface Society’s second dry eye workshop (TFOS DEWS II) noted
the significant shortage of epidemiological data from the southern
hemisphere on the prevalence and risk factors of dry eye disease, thus
the Dunedin Study is ideally placed to address some of these gaps in the
current dry eye literature.
The recently published results from the dry eye arm of the Dunedin
Study showed that the prevalence of dry eye disease was 9% in these
45-year-old New Zealanders 1 . The prevalence rate was comparable to
those reported by the meta-analysis conducted by the TFOS DEWS II
epidemiology subcommittee, which highlighted that, globally, dry eye
disease was present in between 8 and 15% of 40 to 49-year-old adults 2 .
Among those with dry eye disease in the Dunedin Study cohort, a
significant majority (82%) had meibomian gland dysfunction, while
just over one quarter (28%) had aqueous tear deficiency, which is
also consistent with previous studies that report meibomian gland
dysfunction to be the predominant contributor to dry eye disease
worldwide 3,4 . Interestingly, a considerable proportion (37%) of the
study cohort exhibited asymptomatic ocular surface disease which
may, potentially, represent an opportunity for the introduction of
preventative public health strategies. In line with the trends reported
by earlier studies¹, female participants in the Dunedin Study cohort
were more likely to be afflicted with dry eye disease, meibomian gland
dysfunction and asymptomatic ocular surface disease than their male
counterparts.
Future planned analysis of the Dunedin Study will involve
examination of the potential associations and interactions between
mental health, systemic medical conditions and dry eye disease to
facilitate further characterisation of modifiable and non-modifiable
risk factors for the development of dry eye disease. The investigation
of the relationship between human health, development, ageing and
dry eye disease will also enable further exploration of whether ocular
surface and tear film parameters might serve as biomarkers for the
ageing process.
Acknowledgements
We are indebted to the study team and to the study members for their
contribution to this research and are grateful to the Rapanui Trust
(Gisborne) for supporting the purchase of the Oculus Keratograph 5M.
References
1. Craig JP, Wang MTM, Ambler A, Cheyne K, Wilson GA. Characterising the ocular surface and tear film in
a population-based birth cohort of 45-year old New Zealand men and women. Ocul Surf 2020 Aug 13; doi:
10.1016/j.jtos.2020.08.005. Online ahead of print.
2. Stapleton F, Alves M, Bunya VY, Jalbert I, Lekhanont K, Malet F, et al. TFOS DEWS II Epidemiology Report.
Ocul Surf. 2017;15:334-65.
3. Rabensteiner DF, Aminfar H, Boldin I, Schwantzer G, Horwath-Winter J. The prevalence of meibomian gland
dysfunction, tear film and ocular surface parameters in an Austrian dry eye clinic population. Acta Ophthalmol.
2018;96:e707-e11.
4. Rege A, Kulkarni V, Puthran N, Khandgave T. A clinical study of subtype-based prevalence of dry eye. J Clin
Diagn Res. 2013;7:2207-10.
Dr Michael Wang is currently a clinical research fellow and PhD student at the
University of Auckland, Dr Graham Wilson is a Gisborne-based ophthalmologist and
principal investigator for all eye-related matters on the Dunedin Study and A/Prof
Jennifer Craig is an associate investigator on the Dunedin study, based at the Ocular
Surface Laboratory at the University of Auckland.
DED market grows
THE MARKET FOR dry eye disease drugs is expected to continue to
grow significantly regardless of the Covid-19 pandemic.
Driven by a more well-informed eye care professional and public
market, better diagnostic tools and treatments, the global dry eye
drugs market is expected to grow by 11.5% from US$6.97 billion
to US$10.78 billion between 2020 and 2025, according to market
research company 360 Market Updates.
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