Regarding the influence of sex and aging on dry eye disease
Sang Beom Han
Department of Ophthalmology, Kangwon National University Hospital, Kangwon National University Graduate School of Medicine, Chuncheon, Republic of Korea
I read with great interest the article by Ahn et al1 entitled “Sex differences in the effect of aging on dry eye disease”, in which the authors revealed the sex differences in the effect of aging on dry eye disease (DED) in Korean adult population. They also showed the differences in patterns of DED following ocular surgery according to sex.1 The large population-based cross-sectional study was undoubtfully well designed and conducted, and suggests that matching of age and sex is recommended in further researches on DED.1
However, I would like to point out that there exist controversies regarding the effect of aging and sex on DED. Our previous study showed that age had no significant association with the prevalence of DED in adults of 65 years or older, while female sex was significantly related to increased prevalence of DED.2 By contrast, studies in the US demonstrated that prevalence of DED increased with aging both in male and female populations.3,4 Moreover, there are differences in pathophysiology of DED according to age. Although dysfunction of lacrimal and meibomian glands may play an important role in the pathogenesis of DED in the elderly, DED associated with visual display terminal use or contact lens wear is more common in young and middle-aged patients.5 Therefore, I believe these differences in the pathogenesis should be considered in the evaluation of the effects of sex and aging on DED.
Jong Ho Ahn,1 Yoon-Hyeong Choi,2 Hae Jung Paik,1 Mee Kum Kim,3 Won Ryang Wee,3 Dong Hyun Kim1
1Department of Ophthalmology, Gachon University Gil Medical Center, 2Department of Preventive Medicine, Gachon University College of Medicine, Incheon, 3Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
We thank the author for taking a profound interest in our study. We agree with the author’s opinion that there were a few controversial points in this study, and several factors such as psychologic condition, sleep disorder, and visual display terminal use should be considered. However, to the best of our knowledge, there was no report showing a difference in aging effects on DED according to sex, and many epidemiologic studies1–3 including the author’s study, did not consider previous ocular surgery history which could be a major risk factor of DED.
View original paper by Ahn et al.
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