Some systemic medications are reported to be associated with dry eye disease (DED), yet their associations with the severity of DED signs and symptoms are not well studied. To evaluate these associations, we performed a secondary analysis of data from the DRy Eye Assessment and Management (DREAM) Study. Participants (N = 535) were assessed for DED signs using tear break-up time (TBUT), Schirmer testing, corneal fluorescein staining, conjunctival lissamine green staining, meibomian gland dysfunction (MGD), and tear osmolarity and DED symptoms using the Ocular Surface Disease Index (OSDI). We derived a composite signs severity score from the 6 DED signs and categorized participant-reported systemic medications into antidepressants, antihistamines, aspirin, corticosteroids, diuretics, nonsteroidal anti-inflammatory drugs, proton pump inhibitors, statins, vitamin D3, and medications for diabetes mellitus, hypertension, hypothyroidism, migraine, and seizure. Generalized linear models were used to compare DED symptom and sign scores between medication users and non-users, with adjustment for factors associated with DED severity. Compared to non-users, antihistamine users had lower TBUT (p = 0.01) and higher OSDI score (p = 0.02); aspirin users had lower TBUT (p = 0.02); corticosteroid users had lower TBUT (p = 0.02), lower Schirmer test scores (p = 0.03), higher cornea fluorescein staining (p = 0.01), higher composite severity score (p = 0.01), and higher OSDI score (p = 0.03); seizure medication users had higher composite severity score (p = 0.02); vitamin D3 users had lower TBUT (p = 0.001) and greater MGD (p = 0.03); and diuretic users had less MGD (p = 0.03). Certain systemic medications may be associated with more severe DED. This may guide prescription practices in patients with DED.

中文翻译：

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干眼评估和管理 (DREAM) 研究中全身用药与干眼体征和症状严重程度之间的关联

据报道，一些全身药物与干眼病 (DED) 相关，但它们与 DED 体征和症状严重程度的关系尚未得到充分研究。为了评估这些关联，我们对干眼评估和管理 (DREAM) 研究的数据进行了二次分析。使用泪液破裂时间 (TBUT)、Schirmer 测试、角膜荧光素染色、结膜丽丝胺绿染色、睑板腺功能障碍 (MGD) 以及眼表泪液渗透压和 DED 症状来评估参与者 (N = 535) 的 DED 症状疾病指数（OSDI）。我们从 6 个 DED 体征中得出了综合体征严重程度评分，并将参与者报告的全身用药分为抗抑郁药、抗组胺药、阿司匹林、皮质类固醇、利尿剂、非甾体抗炎药、质子泵抑制剂、他汀类药物、维生素 D3 和糖尿病药物、高血压、甲状腺功能减退、偏头痛和癫痫发作。使用广义线性模型来比较药物使用者和非使用者之间的 DED 症状和体征评分，并调整与 DED 严重程度相关的因素。与非使用者相比，抗组胺药使用者的 TBUT 较低（p = 0.01），OSDI 得分较高（p = 0.02）；阿司匹林使用者的 TBUT 较低 (p = 0.02)；皮质类固醇使用者的 TBUT 较低 (p = 0.02)、Schirmer 测试分数较低 (p = 0.03)、角膜荧光素染色较高 (p = 0.01)、综合严重程度分数较高 (p = 0.01) 和 OSDI 分数较高 (p = 0.03) ;癫痫药物使用者的综合严重程度评分较高（p = 0.02）；维生素 D3 使用者的 TBUT 较低（p = 0.001），MGD 较高（p = 0.03）；利尿剂使用者的 MGD 较低 (p = 0.03)。某些全身性药物可能与更严重的干眼症有关。这可以指导 DED 患者的处方实践。