Association between lid margin collarettes and dry eye disease severity in the Dry Eye Assessment and Management (DREAM) study
Abstract
Background/objectives: Lid margin collarettes are a distinct clinical finding and their association with meibomian gland dysfunction (MGD) and dry eye symptoms and signs remains uncertain. We leverage the large cohort of subjects in the Dry Eye Assessment and Management (DREAM) study data to elucidate collarettes' impact on dry eye disease (DED).
Subjects/methods: We performed secondary analysis of DREAM study data, a multicentre, double-blinded clinical trial evaluating omega-3 supplementation in patients with moderate-to-severe DED. DED symptoms (Ocular Surface Disease Index [OSDI] and Ocular Discomfort) and signs (conjunctival staining, corneal staining, tear break-up time (TBUT), Schirmer test, MGD grade) were compared by collarette presence and severity. Data from all visits (baseline, months 3, 6, 12) were assessed and adjusted for demographics and baseline comorbidities.
Results: Of 1070 eyes at baseline, 65.3% had no collarettes, 28.0% had 1-5, and 6.6% had 6-20. Over the 1 year period of the study, 67% of eyes had no change in collarette severity, while 19% had increased severity and 14% had decreased severity. Collarettes were more common in Whites (82.1% vs 69.9%, p = 0.001), non-Hispanics (92.3% vs 83.2%, p = 0.006), and those with facial rosacea (25.0% vs 17.7%, p = 0.05). Multivariate analysis showed collarettes were associated with increased corneal staining (5.06 vs 4.59, p = 0.01), decreased TBUT (3.24 vs 3.54 s, p = 0.01), decreased Schirmer test (7.92 vs…
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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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