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

Atsuko Eguchi, Takenori Inomata, Masahiro Nakamura, Ken Nagino, Masao Iwagami, Jaemyoung Sung, Akie Midorikawa-Inomata, Yuichi Okumura, Kenta Fujio, Keiichi Fujimoto, Maria Miura, Yasutsugu Akasaki, Hurramhon Shokirova, Kunihiko Hirosawa, Mizu Kuwahara, Jun Zhu, Reza Dana, Akira Murakami, Hiroyuki Kobayashi

Journal: Japanese journal of ophthalmology 2021;65(2):271-281

PMID: 33411099

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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.

Address: Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan.; Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan. [email protected].; Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Tokyo, 113-0033, Japan. [email protected].; Department of Ophthalmology, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan. [email protected].; Department of Strategic Operating Room Management and Improvement, Juntendo University Graduate School of Medicine, Tokyo, Japan. [email protected].; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. [email protected].; Department of Ophthalmology, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan.; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.; Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.; Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Tokyo, 113-0033, Japan.; Morsani College of Medicine, University of South Florida, Tampa, FL, USA.; Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Tokyo, 113-0033, Japan.; Department of Strategic Operating Room Management and Improvement, Juntendo University Graduate School of Medicine, Tokyo, Japan.; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.; Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Tokyo, 113-0033, Japan.; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.; Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Tokyo, 113-0033, Japan.; Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Tokyo, 113-0033, Japan.; Department of Ophthalmology, Subei People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China.; Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.; Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Tokyo, 113-0033, Japan.; Department of Ophthalmology, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan.; Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

DOI: 10.1007/s10384-020-00798-1

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

MeSH Terms: Crowdsourcing, Dry Eye Syndromes, Humans, Japan, Lubricant Eye Drops, Ophthalmic Solutions, Tears