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Clinical Aspects of Patients with Dry Eye Disease according to Helicobacter Pylori Infection

Author(s): Seunghyun Lee, Sangmin Nam, Helen Lew

Purpose: To compare the clinical aspects of patients with dry eye disease according to infection of Helicobacter pylori (H.pylori) using urea breath test which is non-invasive and find out the correlation of dry eye and H.pylori infection.

Methods: We detected the infection of H.pylori using urea breath test (BreathTek®, Otsuka America Pharmaceutical, Inc., USA) in 52 patients with dry eye disease from August 2018 to December 2019 and analyzed their medical records. Slit lamp examination, Ocular Surface Diseast Index (OSDI) questionnaire were performed. Tear meniscus height was measured by optical coherence tomography (Spectralis, Heidelberg Engineering, Heidelberg, Germany). Lipid layer thickness, total blinking rate, partial blinking rate and meiboscore were measured by ocular surface interferometer (Tear Science, Morrisville, NC, USA).

Results: The number of people who were positive for urea breath test was 17 (32.7%) and negative for test was 35 (67.3%). There were no differences in age, sex, tear meniscus height, lipid layer thickness, total blinking rate for one minute and partial blinking rate according to H.pylori infection. The OSDI scores (39.7, 28.5) and rate of severe loss of meibomian glands (23.5%, 4.3%) were significantly higher in the H.pylori positive group (p<0.05). The rate of patients diagnosed with Sjogren's syndrome (35.3%, 17.1%) was also significantly higher in the H.pylori positive group(p<0.05).

Conclusion: When urea breath test for H.pylori infection was positive in the dry eye patients, they presented mixed type of aqueous tear-deficient and evaporative type. Through detailed history taking for patients with dry eye, we could more actively suspect Sjogren's syndrome and conduct additional tests.

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