Dry eye assessment in patients with vitiligo

Purpose:To evaluate tear osmolarity and tear film parameters in patients with vitiligo.Methods:A total of 25 eyes of 25 patients with vitiligo with periocular involvement (group 1), 30 eyes of 30 patients with vitiligo without periocular involvement (group 2), and 20 eyes of 20 controls (group 3) were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film breakup time, scoring of ocular surface fluorescein staining using a modified Oxford scale, and tear osmolarity.Results:Mean tear osmolarity was 332 16.3 mOsm/L in group 1, 308.8 +/- 19.5 mOsm/L in group 2, and 286.3 +/- 23.4 mOsm/L in group 3 (P < 0.001). There was no significant difference in Schirmer I test results among the 3 groups (16.5 +/- 3.2 mm in group 1, 16.3 +/- 4.7 mm in group 2, and 17.4 +/- 4.2 mm in group 3) (P = 0.175). Tear film breakup time measurements in groups 1 (9.8 +/- 3.5 seconds) and 2 (10.1 +/- 4.3 seconds) were significantly lower than those in group 3 (18.5 +/- 4.0 seconds) (P <0.001). There was no significant difference among the 3 groups on the Oxford scale (0.04 +/- 0.70 in group 1, 0.03 +/- 0.33 in group 2, and 0.03 +/- 0.20 in group 3) (P = 0.865). The mean Ocular Surface Disease Index score was significantly higher in groups 1 and 2 than in group 3 (42.1 +/- 16.5 in group 1, 39.9 +/- 17.3 in group 2, and 12.3 +/- 11.6 in group 3) (P <0.001). Conclusions:This study showed that vitiligo is associated with tear hyperosmolarity and tear film dysfunction. Patients with vitiligo with periocular involvement may be more prone to dry eye than those without ocular involvement.