Nuovo Poster GOAL a ESCRS 2018 Ocular surface disease and laryngo-pharyngeal reflux: new physiopathogenetic hypotheses
Ocular surface disease and laryngo-pharyngeal reflux: new physiopathogenetic hypotheses
First Author: : P.Marino
Co Author(s): : D. Passali A. Balestrazzi V. Damiani D. Mazzacane
Ocular surface disease (OSD) is a pathology due to two physiopathogenetic mechanisms: the reduced production and / or iper evaporation of the tears film with increased osmolarity and consequent inflammation of the anterior surface of the eye For this reason the current therapy is represented by artificial tears, surface stabilizers, anti-inflammatory drugs. Using two validated diagnostic tools: the ocular surface disease index (OSDI) and the reflux simptoms index (RSI), which application is also possible in basic outpatients environments, we have evaluated the possible existence of a physiopathogenetic correlation between OSD and laryngo-pharingeal reflux (LPR).
The study took place in the territorial eye clinics of the Italian health service which are characterized by a high flow of users and a low-tech instrumental kit, involving 19 experimenters spread homogeneously in Piedmont, Lombardy, Veneto, Lazio, Emilia Romagna, Campania, Calabria and Sicily.
Patients of both sexes, pertaining sequentially to the territorial eye clinics, in the presence of signs and / or symptoms related to suspected tear dysfunction syndrome, underwent Ocular Surface Desease Index and Reflux Symptom Index administration.
The present study analysed 290 patients, subdivided in two sub-groups on the basis of the RSI score: normal RSI: < 13, and abnormal RSI: > 13. RSI negative group consisted of 189 (65.2%) subjects; RSI positive group consisted of 101 (34.8%) subjects. The OSDI outcomes were analysed considering both the 3 individual items, such as ocular symptoms, vision-related function, and environmental triggers, and the global score. Noteworthy, all single items and global scores were significantly higher in patients with abnormal RSI (p<0.0001, each comparison). A moderate (r = 0.58) correlation between total OSDI score and RSI scores was detected.
Current study showed that LPR may be common in patients with OSD (34% of patients in our sample) and an OSDI score > 42 may be predictive for positive RSI. For this reason it would be desirable to include in the flow chart management of severe OSD, the investigation and the therapy of the eventual LPR.