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Heterogeneity of eye drop use among symptomatic dry eye individuals in Japan: large-scale crowdsourced research using DryEyeRhythm application

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To determine eye drop type and usage frequency and investigate risk factors for no eye drop use in individuals with symptomatic dry eye (DE) in Japan.

Study design

Crowdsourced observational study.

Methods

This study was conducted using the DryEyeRhythm smartphone application between November 2016 and September 2019. Data collected included the type and frequency of eye drop use, demographics, medical history, lifestyle, and self-reported symptoms. Symptomatic DE was defined as an Ocular Surface Disease Index total score of ≥ 13. Risk factors for no eye drop use were identified using multivariate logistic regression analyses.

Results

Among 2619 individuals with symptomatic DE, 1876 did not use eye drops. The most common eye drop type was artificial tears (53.4%), followed by hyaluronic acid 0.1% (33.1%) and diquafosol sodium 3% (18.7%). Risk factors (odds ratio [95% confidence interval]) for no eye drop use were age (0.97 [0.97–0.98]), body mass index (1.04 [1.01–1.07]), brain disease (0.38 [0.15–0.98]), collagen disease (0.30 [0.13–0.68]), mental illness other than depression and schizophrenia (0.65 [0.45–0.93]), cataract surgery (0.12 [0.02–0.59]), ophthalmic surgery other than cataract and laser-assisted in situ keratomileusis (0.55 [0.34–0.88]), current (0.47 [0.38–0.57]) or past (0.58 [0.43–0.77]) contact lens use, >8 h screen exposure time (1.38 [1.05–1.81]), <6 h (1.24 [1.01–1.52]) and >9 h (1.34 [1.04–1.72]) sleep time, and water intake (0.97 [0.94–0.98]).

Conclusion

Many participants with symptomatic DE did not use optimized eye drop treatment and identified risk factors for no eye drop use. The DryEyeRhythm application may help improve DE treatment.

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References

  1. Craig JP, Nichols KK, Akpek EK, Caffery B, Dua HS, Joo CK, et al. TFOS DEWS II Definition and Classification Report. Ocul Surf. 2017;15:276–83.

    Article  Google Scholar 

  2. Stapleton F, Alves M, Bunya VY, Jalbert I, Lekhanont K, Malet F, et al. TFOS DEWS II Epidemiology Report. Ocul Surf. 2017;15:334–65. https://doi.org/10.1016/j.jtos.2017.05.003.

    Article  PubMed  Google Scholar 

  3. Hikichi T, Yoshida A, Fukui Y, Hamano T, Ri M, Araki K, et al. Results of a population-based questionnaire on the symptoms and lifestyles associated with dry eye. Cornea. 1999;18:408–11.

    Article  Google Scholar 

  4. Shimmura S, Shimazaki J, Tsubota K. Results of a population-based questionnaire on the symptoms and lifestyles associated with dry eye. Cornea. 1999;18:408–11.

    Article  CAS  Google Scholar 

  5. Uchino M, Nishiwaki Y, Michikawa T, Shirakawa K, Kuwahara E, Yamada M, et al. Prevalence and risk factors of dry eye disease in Japan: Koumi study. Ophthalmology. 2011;118:2361–7.

    Article  Google Scholar 

  6. Uchino M, Yokoi N, Uchino Y, Dogru M, Kawashima M, Komuro A, et al. Prevalence of dry eye disease and its risk factors in visual display terminal users: the Osaka study. Am J Ophthalmol. 2013;156:759–66.

    Article  Google Scholar 

  7. Inomata T, Shiang T, Iwagami M, Sakemi F, Fujimoto K, Okumura Y, et al. Changes in distribution of dry eye disease by the new 2016 diagnostic criteria from the Asia Dry Eye Society. Sci Rep. 2018;8:1918.

    Article  Google Scholar 

  8. Courtin R, Pereira B, Naughton G, Chamoux A, Chiambaretta F, Lanhers C, et al. Prevalence of dry eye disease in visual display terminal workers: a systematic review and meta-analysis. BMJ Open. 2016;6:e009675.

    Article  Google Scholar 

  9. Inomata T, Iwagami M, Nakamura M, Shiang T, Yoshimura Y, Fujimoto K, et al. Characteristics and risk factors associated with diagnosed and undiagnosed symptomatic dry eye using a smartphone application. JAMA Ophthalmol. 2019;138:58–68.

    Article  Google Scholar 

  10. Uchino M, Schaumberg DA. Dry eye disease: impact on quality of life and vision. Curr Ophthalmol Rep. 2013;1:51–7.

    Article  Google Scholar 

  11. Yamada M, Mizuno Y, Shigeyasu C. Impact of dry eye on work productivity. Clinicoecon Outcomes Res. 2012;4:307–12.

    Article  Google Scholar 

  12. Yokoi N, Georgiev GA. Tear film-oriented diagnosis and tear film-oriented therapy for dry eye based on tear film dynamics. Investig Ophthalmol Vis Sci. 2018;59:13–22.

    Article  Google Scholar 

  13. Jones L, Downie LE, Korb D, Benitez-Del-Castillo JM, Dana R, Deng SX, et al. TFOS DEWS II Management and Therapy Report. Ocul Surf. 2017;15:575–628.

    Article  Google Scholar 

  14. Poon KH, Yeo S, Tong L. Lost to follow-up for appointments in a dedicated dry eye clinic. Patient Prefer Adherence. 2014;8:1409–18.

    PubMed  PubMed Central  Google Scholar 

  15. Narayan V. Pharmaceutical ophthalmic market perspectivees in India and emerging trends. CLEVER. 2018;1:35–7.

    Article  Google Scholar 

  16. Kawashima M, Yamada M, Suwaki K, Shigeyasu C, Uchino M, Hiratsuka Y, et al. A clinic-based survey of clinical characteristics and practice pattern of dry eye in Japan. Adv Ther. 2017;34:732–43.

    Article  Google Scholar 

  17. Uchino M, Yokoi N, Kawashima M, Ryutaro Y, Uchino Y, Tsubota K. Treatment trends in dry eye disease and factors associated with ophthalmic follow-up discontinuation in Japan. J Clin Med. 2019;8:1120.

    Article  Google Scholar 

  18. Mizuno Y, Yamada M, Shigeyasu C. Annual direct cost of dry eye in Japan. Clin Ophthalmol. 2012;6:755–60.

    Article  Google Scholar 

  19. World Health Organization. mHealth: new horizons for health through mobile technologies: second global survey on eHealth; 2011. https://www.who.int/goe/publications/goe_mhealth_web.pdf. Accessed 6 Dec 2019.

  20. Byambasuren O, Sanders S, Beller E, Glasziou P. Prescribable mHealth apps identified from an overview of systematic reviews. NPJ Digit Med. 2018;1:12.

    Article  Google Scholar 

  21. Inomata T, Nakamura M, Iwagami M, Shiang T, Yoshimura Y, Fujimoto K, et al. Risk factors for severe dry eye disease: crowdsourced research using DryEyeRhythm. Ophthalmology. 2019;126:766–8.

    Article  Google Scholar 

  22. Inomata T, Iwagami M, Nakamura M, Shiang T, Fujimoto K, Okumura Y, et al. Association between dry eye and depressive symptoms: large-scale crowdsourced research using the DryEyeRhythm iPhone application. Ocul Surf. 2020;18:312–9.

    Article  Google Scholar 

  23. Pereira AM, Jácome C, Almeida R, Fonseca JA. How the smartphone is changing allergy diagnostics. Curr Allergy Asthma Rep. 2018;18:69.

    Article  Google Scholar 

  24. World Medical Association. Worl Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310:2191–4.

    Article  Google Scholar 

  25. Midorikawa-Inomata A, Inomata T, Nojiri S, Nakamura M, Iwagami M, Fujimoto K, et al. Reliability and validity of the Japanese version of the Ocular Surface Disease Index for dry eye disease. BMJ Open. 2019;9:e033940.

    Article  Google Scholar 

  26. Zung WW. A Self-Rating Depression Scale. Arch Gen Psychiatry. 1965;12:63–70.

    Article  CAS  Google Scholar 

  27. Schiffman RM, Christianson MD, Jacobsen G, Hirsch JD, Reis BL. Reliability and validity of the Ocular Surface Disease Index. Arch Ophthalmol. 2000;118:615–21.

    Article  CAS  Google Scholar 

  28. Inomata T, Nakamura M, Iwagami M, Midorikawa-Inomata A, Okumura Y, Fujimoto K, et al. Comparing the Japanese version of the ocular surface disease index and dry eye-related quality-of-life score for dry eye symptom assessment. Diagnostics (Basel). 2020;10:203.

    Article  CAS  Google Scholar 

  29. Miller KL, Walt JG, Mink DR, Satram-Hoang S, Wilson SE, Perry HD, et al. Minimal clinically important difference for the ocular surface disease index. Arch Ophthalmol. 2010;128:94–101.

    Article  Google Scholar 

  30. Kim KW, Han SB, Han ER, Woo SJ, Lee JJ, Yoon JC, et al. Association between depression and dry eye disease in an elderly population. Investig Ophthalmol Vis Sci. 2011;52:7954–8.

    Article  Google Scholar 

  31. Yazdani C, McLaughlin T, Smeeding JE, Walt J. Prevalence of treated dry eye disease in a managed care population. Clin Ther. 2001;23:1672–82.

    Article  CAS  Google Scholar 

  32. Watanabe H. Medical treatment for dry eye in Japan. Investig Ophthalmol Vis Sci. 2018;59:des116–20.

    Article  CAS  Google Scholar 

  33. Wolffsohn JS, Arita R, Chalmers R, Djalilian A, Dogru M, Dumbleton K, et al. TFOS DEWS II Diagnostic Methodology Report. Ocul Surf. 2017;15:539–74.

    Article  Google Scholar 

  34. Inomata T, Iwagami M, Hiratsuka Y, Fujimoto K, Okumura Y, Shiang T, et al. Maximum blink interval is associated with tear film breakup time: a new simple, screening test for dry eye disease. Sci Rep. 2018;8:13443.

    Article  Google Scholar 

  35. Fujimoto K, Inomata T, Okumura Y, Iwata N, Fujio K, Eguchi A, et al. Comparison of corneal thickness in patients with dry eye disease using the Pentacam rotating Scheimpflug camera and anterior segment optical coherence tomography. PLoS ONE. 2020;15:e0228567.

    Article  CAS  Google Scholar 

  36. Inomata T, Sung J, Nakamura M, Fujisawa K, Muto K, Ebihara N, et al. New medical big data for P4 medicine on allergic conjunctivitis. Allergol Int. 2020;69:510–8.

    Article  CAS  Google Scholar 

  37. Jardine J, Fisher J, Carrick B. Apple’s ResearchKit: smart data collection for the smartphone era? J R Soc Med. 2015;108:294–6.

    Article  Google Scholar 

  38. Heidari M, Noorizadeh F, Wu K, Inomata T, Mashaghi A. Dry eye disease: emerging approaches to disease analysis and therapy. J Clin Med. 2020;8:751–60.

    Google Scholar 

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Acknowledgements

Special thanks to OHAKO, Inc. (Tokyo, Japan) for developing the DryEyeRhythm application and Shiang T, Yoshimura Y, Hirastuka Y, Uchino M, and Tsubota K for initiating the development of the application.

Funding

This study was supported by SEED Co., Ltd (Tokyo, Japan), Alcon Japan, Ltd, Tokyo Japan; Rohto Pharmaceutical Co., Ltd, Osaka, Japan; HOYA Corporation, Tokyo, Japan; and WAKAMOTO Co., Ltd, Tokyo, Japan. The sponsors had no role in the design or conduct of this research.

Author information

Authors and Affiliations

  1. Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan

    Atsuko Eguchi, Takenori Inomata, Ken Nagino, Akie Midorikawa-Inomata & Hiroyuki Kobayashi

  2. Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Tokyo, 113-0033, Japan

    Takenori Inomata, Jaemyoung Sung, Yuichi Okumura, Kenta Fujio, Keiichi Fujimoto, Maria Miura, Yasutsugu Akasaki, Hurramhon Shokirova, Kunihiko Hirosawa, Mizu Kuwahara, Jun Zhu & Akira Murakami

  3. Department of Ophthalmology, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan

    Takenori Inomata, Masahiro Nakamura & Akira Murakami

  4. Department of Strategic Operating Room Management and Improvement, Juntendo University Graduate School of Medicine, Tokyo, Japan

    Takenori Inomata & Yuichi Okumura

  5. Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan

    Takenori Inomata, Masahiro Nakamura, Yuichi Okumura, Kenta Fujio, Keiichi Fujimoto, Maria Miura, Yasutsugu Akasaki, Kunihiko Hirosawa, Mizu Kuwahara & Akira Murakami

  6. Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan

    Masao Iwagami

  7. Morsani College of Medicine, University of South Florida, Tampa, FL, USA

    Jaemyoung Sung

  8. Department of Ophthalmology, Subei People’s Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China

    Jun Zhu

  9. Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA

    Reza Dana

Authors
  1. Atsuko Eguchi
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  2. Takenori Inomata
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  11. Maria Miura
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  15. Mizu Kuwahara
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  16. Jun Zhu
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  18. Akira Murakami
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  19. Hiroyuki Kobayashi
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Corresponding author

Correspondence to Takenori Inomata.

Ethics declarations

Conflicts of interest

The DryEyeRhythm application was developed by OHAKO, Inc. (Tokyo, Japan), using Apple’s ResearchKit (Cupertino, CA, USA). The authors do not have any conflict of interest relevant to this study.

A. Eguchi, None; T. Inomata, Grant (Johnson & Johnson, Kowa, Novartis, Santen, SEED, HOGY), Consultant fee (Santen); M. Nakamura, None; K. Nagino, None; M. Iwagami, None; J. Sung, None; A. Midorikawa-Inomata, None; Y. Okumura, None; K. Fujio, None; K. Fujimoto, None; M. Miura, None; Y. Akasaki, None; H. Shokirova, None; K. Hirosawa, None; M. Kuwahara, None; J. Zhu, None; R. Dana, Financial support (Dompé, Aldeyra, Kala); A. Murakami, Grant (Eisai, Kowa, Novartis, HOYA, ROHTO, Alcon, AMO, Otsuka, SEED, Senju, Pfizer, Santen), Financial support (Johnson & Johnson, Kowa, Lion, Alcon, Santen, Otsuka); H. Kobayashi, None.

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Corresponding Author: Takenori Inomata

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Eguchi, A., Inomata, T., Nakamura, M. et al. Heterogeneity of eye drop use among symptomatic dry eye individuals in Japan: large-scale crowdsourced research using DryEyeRhythm application. Jpn J Ophthalmol 65, 271–281 (2021). https://doi.org/10.1007/s10384-020-00798-1

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  • DOI: https://doi.org/10.1007/s10384-020-00798-1

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