TFOS DEWS II Sex, Gender, and Hormones Report

Sullivan, David A.; Rocha, Eduardo Melani; Aragona, Pasquale; Clayton, Janine Austin; Ding, Juan; Golebiowski, Blanka; Hampel, Ulrike; McDermott, Alison M.; Schaumberg, Debra A.; Srinivasan, Sruthi; Versura, Piera; Willcox, Mark

doi:10.1016/j.jtos.2017.04.001

Cited by 296 publications

(296 citation statements)

References 830 publications

(782 reference statements)

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“…Where sex refers to the anatomy of an individual's reproductive system and functions that derive from the chromosomal complement, gender refers to a person's self-representation as male or female or how that person is responded to by social institutions on the basis of the individual's gender presentation. 26 As the feminine gender role is generally associated with a greater willingness to report pain 4 , this might be another cause of increased OSDI scores in our female patients.…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 88%

“…2 Dry eye disease (DED) is no exception, as numerous epidemiological studies have shown that DED is far more prevalent in women than in men and biological studies have shown that sex has a major influence on the regulation of the ocular surface and adnexa. 3,4 Different underlying mechanisms of pathophysiology have been proposed, such as a possible important role for sex steroids and other hormone imbalances in women. 4 However, despite all the epidemiological and biological studies, there is still a surprisingly lack of knowledge about the influence of sex in clinical characteristics of DED.…”

Section: Introductionmentioning

confidence: 99%

“…3,4 Different underlying mechanisms of pathophysiology have been proposed, such as a possible important role for sex steroids and other hormone imbalances in women. 4 However, despite all the epidemiological and biological studies, there is still a surprisingly lack of knowledge about the influence of sex in clinical characteristics of DED. To our knowledge, only one study has reported sex differences in total symptoms of DED, showing more symptoms in women.…”

Section: Introductionmentioning

confidence: 99%

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Sex differences in clinical characteristics of dry eye disease

et al. 2018

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Please cite this article as: Vehof J, Sillevis Smitt-Kamminga N, Nibourg SA, Hammond CJ, Sex differences in clinical characteristics of dry eye disease, Ocular Surface (2018), doi: 10.1016/ j.jtos.2018.01.001. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusions: This large clinical study has shown that sex has a large influence on the symptomatology of DED, with significantly higher symptom scores and lower correlation between symptoms and signs in women compared to men. These findings are of importance in clinical practice and in conducting research into DED.

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Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sex differences in clinical characteristics of dry eye disease

et al. 2018

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Section: Introductionmentioning

confidence: 99%

“…Androgen insufficiency, in turn, is a significant risk factor for the development of MGD [1, 5-7]. Androgens stimulate meibomian gland function, which plays a critical role in the health of the eye [5, 7]. These glands produce and release a proteinaceous lipid mixture (i.e., meibum) that promotes stability and prevents evaporation of the tear film [1, 3, 8].…”

Section: Introductionmentioning

confidence: 99%

Meibomian Gland Dysfunction in Primary and Secondary Sjögren Syndrome

et al. 2018

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Purpose: We hypothesized that women with primary (pSS) and secondary Sjögren syndrome (sSS; with systemic lupus erythematosus [SLE] or rheumatoid arthritis [RA]) have meibomian gland dysfunction (MGD). We sought to test our hypothesis. Methods: Subjects with pSS, sSS + SLE, sSS + RA, and non-SS-related MGD were recruited from the Sjögren’s Syndrome Foundation or outpatient clinics at Tufts University School of Dental Medicine or Brigham and Women’s Hospital. The control population was recruited from the Greater Boston area. After providing written informed consent, the subjects underwent an eye examination and/or completed two questionnaires that assess symptoms of dry eye disease (DED). Results: Our results demonstrate that pSS and sSS patients have MGD. These subjects had meibomian gland orifice metaplasia, an increased number of occluded meibomian gland orifices, and a reduced quality of meibomian gland secretions. Further, patients with pSS, sSS + SLE, sSS + RA, and MGD had significant alterations in their tear film, lid margin, cornea, and conjunctiva. Symptoms of DED were increased ∼10-fold in all pSS, sSS, and MGD groups relative to controls. Conclusions: Our findings support our hypothesis and show that individuals with pSS, sSS + SLE, and sSS + RA have MGD. In addition, our study indicates that patients with pSS and sSS have both aqueous-deficient and evaporative DED.

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Comparison of Sodium-Glucose Cotransporter 2 Inhibitors vs Glucagonlike Peptide-1 Receptor Agonists and Incidence of Dry Eye Disease in Patients With Type 2 Diabetes in Taiwan

Hung

Chang

et al. 2022

JAMA Netw Open

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ImportanceSodium-glucose cotransporter 2 (SGLT2) inhibitors have been found to improve low-grade systemic and tissue inflammation; however, the association between SGLT2 inhibitor use and the incidence of dry eye disease (DED) has not been explored.ObjectiveTo investigate the association between SGLT2 inhibitor use and dry eye disease in patients with type 2 diabetes (T2D).Design, Setting, and ParticipantsA retrospective cohort analysis of the largest multi-institutional electronic medical records database in Taiwan was conducted to identify patients with T2D newly receiving SGLT2 inhibitors or glucagonlike peptide-1 receptor agonists (GLP-1 RAs) from 2016 to 2018. Data analysis was performed from March 1 to May 31, 2022. Propensity scores with inverse probability of treatment weighting were generated to enable homogeneous comparisons between the 2 groups.ExposuresTreatment with SGLT2 inhibitors or GLP-1 RAs.Main Outcomes and MeasuresIncident dry eye disease, which was defined by clinical diagnoses, plus the related drug prescription. Cox proportional hazards regression models were used to estimate hazard ratios with 95% CIs for the risk of DED.ResultsA total of 10 038 and 1077 T2D patients newly receiving SGLT2 inhibitors (mean [SD] age, 59.5 [12.1] years; 5689 [56.7%] men) or GLP-1 RAs (mean [SD] age, 58.5 [41.2] years; 587 [54.5%] men), respectively, were included in the analysis. The incidence of DED was lower in patients newly receiving SGLT2 inhibitors (9.0 events per 1000 person-years) compared with those receiving GLP-1 RAs (11.5 events per 1000 person-years), yielding a hazard ratio of 0.78 (95% CI, 0.68-0.89). Subgroup analyses indicated that the lowered DED risks associated with SGLT2 inhibitors in patients with T2D were similar across different age, sex, blood glucose level, and kidney function groups. Results from the sensitivity analyses (including the propensity score–matching approach, on-treatment analyses, and different follow-up periods of 1, 2, and 3 years) were similar to the main analyses.Conclusions and RelevanceThe findings of this study suggest that patients with T2D newly receiving SGLT2 inhibitors may have a lower risk for DED compared with those receiving GLP-1 RAs. Prospective studies are needed to analyze these results.

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TFOS DEWS II Sex, Gender, and Hormones Report

Cited by 296 publications

References 830 publications

Sex differences in clinical characteristics of dry eye disease

Sex differences in clinical characteristics of dry eye disease

Meibomian Gland Dysfunction in Primary and Secondary Sjögren Syndrome

Comparison of Sodium-Glucose Cotransporter 2 Inhibitors vs Glucagonlike Peptide-1 Receptor Agonists and Incidence of Dry Eye Disease in Patients With Type 2 Diabetes in Taiwan

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