Dry eye syndrome and the subsequent risk of chronic fatigue syndrome—a prospective population-based study in Taiwan

Abstract

Background and AimThe clinical association between dry eye syndrome (DES) and chronic fatigue syndrome (CFS) remain unclear with less evidences. We aimed to investigate the relationship between CFS and DES using a national insurance and prospective cohort study.MethodsData from the Longitudinal Health Insurance Database 2000 was applied to estimate the incidence of CFS among patients with DES, and their age- and sex-matched controls without DES over a long-term follow-up period. All participants were CFS free at baseline, before the interval (2005–2007), but were later diagnosed with CFS. DES patients and its relative matched controls were excluded prevalent CFS before the same interval.ResultsWe identified 884 patients with DES and 3,536 matched controls in baseline and estimated the hazard ratios for incident CFS in the follow-up period. Patients with DES had a 2.08-fold considerably increasing risk of developing CFS, compared to non-DES group. An elevated risk of developing CFS remained (1.61-fold risk) even after adjusting for age, sex, and comorbidities. There was a presence of increasing risk in DES-related CFS when CFS-related comorbidities existing (adjusted hazard ratio, 1.98, 95% confidence interval, 1.19–3.29; p < 0.01). The subsequent risk for CFS between DES and non-DES patients was significant increased with three or more annual medical visits, the adjusted risk for CFS was 4.88-fold risk (95% CI, 2.26–10.58, p < 0.001).ConclusionWe recommended that physicians should be aware of the increased risk of CFS among DES patients and adequately assess the health impacts among these patients.

Ocular manifestations and biomarkers of Gulf War Illness in US veterans

“…In this study, we did not detect significant differences in the overall frequency of age-related eye diseases in individuals with GWI. However, dry eye symptoms were significantly more common in GWI compared to controls, which aligns with other diseases that have similar symptomology, such as fibromyalgia and chronic fatigue syndrome 5 , 6 . There are many potential contributors to the noted association, including systemic inflammatory processes that lead to ocular surface inflammation and peripheral and/or central nerve abnormalities that lead to persistent symptoms of dryness 19 , 20 .…”

“…Thus veterans with GWI may be at increased risk for age-related eye disease and this association should be explored. Furthermore, GWI may specifically be at risk for dry eye (DE) given the overlap in symptom profile between GWI, fibromyalgia, and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), the latter two of which have been associated with DE symptoms 5 , 6 . Given these data, we hypothesized that individuals with GWI have a higher frequency of age-related eye diseases, including DE symptoms, compared to GWE veterans that do not meet GWI diagnostic criteria.…”

Dry Eye Disease: A Review of Epidemiology in Taiwan, and its Clinical Treatment and Merits

“…In addition to Sjogren's syndrome, a higher risk of chronic fatigue syndrome, and oral cavity cancer was also found in the patients with DED [37,38]. Furthermore, environmental factors such as carbon monoxide (CO), nitrogen dioxide (NO 2 ), and temperature were positively associated with dry eye disease, while relative humidity was negatively related [39].…”

Dry eye symptoms and signs in United States Gulf War era veterans with myalgic encephalomyelitis/chronic fatigue syndrome

“…The authors noted an increased risk of ME/CFS development in individuals with a DE diagnosis compared to controls over a 2-year period (hazard ratio [HR]: 1.6, 95% confidence interval [CI], 1.0-2.6, p < 0.05). 28 To better characterise ocular manifestations of ME/CFS and examine the contribution peripheral markers of inflammation, we examined a cohort of veterans split into categories by ME/CFS status and examined which DE metrics and blood inflammatory markers most closely related to disease.…”

“…None of the individuals had a diagnosis of ME/CFS at baseline. The authors noted an increased risk of ME/CFS development in individuals with a DE diagnosis compared to controls over a 2‐year period (hazard ratio [HR]: 1.6, 95% confidence interval [CI], 1.0–2.6, p < 0.05) 28 …”