The association of dry eye disease signs and symptoms with anxiety and depression: An observational study

Abstract

Purpose This study aimed to determine the relationship between dry eye-related symptoms and signs with anxiety and depression. Methods In this observational study, we recruited 63 volunteers, including 51 patients with dry eye disease (DED) and 12 healthy volunteers. Infrared images of the meibomian gland and corneal nerve layer analysis of all patients were assessed. Additionally, the patients completed Hospital Anxiety and Depression Scale (HADS) questionnaire, Ocular Surface Disease Index (OSDI), and dry eye symptom questionnaire. Results HADS-anxiety and HADS-depression scores in the DED group were significantly higher than those in the control group (t = 5.846, P \(<\) 0.001, and t = 4.006, P \(<\) 0.001, respectively). HADS-anxiety and HADS-depression was significantly correlated with DED symptoms (P < 0.05). There was a significant positive correlation between the OSDI and HADS (P < 0.001). There was a significant correlation between HADS-anxiety and mebomian gland area (r = -0.426, P < 0.001) and corneal nerve density (r = -0.345, P < 0.001); HADS-depression was found to be correlated with mebomian gland area (r = -0.517, P < 0.001) and corneal nerve density (r = -0.242, P = 0.016). The predictive equation for HADS-anxiety is as follows: HADS-anxiety = 0.09989*OSDI + -0.00013*CND + -22.54*MGA + 7.128 (P < 0.0001). The predictive equation for HADS-depression is as follows: HADS-depression = 0.06743*OSDI + -18.01*MGA + 5.019 (P < 0.0001). Conclusion Anxiety and depression were significantly correlated with OSDI, CND and MGA in patients with DED. Furthermore, OSDI, CND and MGA have a relatively value for HADS-anxiety and HADS-depression.