Dry eye disease is associated with retinal microvascular dysfunction and possible risk for cardiovascular disease

Hala Shokr, James S. Wolffsohn, Sonia Trave Huarte, Emily Scarpello, Doina Gherghel

Research output: Contribution to journalArticlepeer-review


Purpose To explore the presence of microvascular endothelial dysfunction as a measure for early cardiovascular disease in individuals diagnosed with dry eye disease (DED) as compared to age‐matched normal controls. Methods Systemic blood pressure, Body Mass Index, intraocular pressure, blood levels of glucose (GLUC), triglycerides, cholesterol (CHOL), high‐density lipoprotein cholesterol (HDL‐C), and low‐density lipoprotein cholesterol (LDL‐C)] as well as retinal and peripheral microvascular function were assessed in twenty‐five 35–50 year olds with diagnosed with DEDa (using the TFOS DEWS II criteria) and 25 age and sex‐matched controls. Results After controlling all the influential covariates, individuals diagnosed with DED exhibited significant lower retinal artery baseline (p = 0.027), artery maximum diameter (p = 0.027), minimum constriction (p = 0.039) and dilation amplitude (p = 0.029) than controls. In addition, the time to reach the vein maximum diameter was significantly longer in the DED patients than in normal controls (p = 0.0052). Only in individuals diagnosed with DED, artery maximum constriction correlated statistically significantly and positively with HDL‐C blood levels (p = 0.006). Similarly, artery slopeAD correlated positively with T‐CHOL and LDL‐C (p = 0.006 & 0.011 respectively). Additionally, artery baseline diameter and maximum constriction were significantly and negatively correlated to T‐CHOL/HDL‐C ratio (p = 0.032 and p = 0.013 respectively) in DED individuals only. Conclusions Individuals with positive diagnosis of DED exhibit abnormal retinal microvascular function and possible higher risk for CVD.
Original languageEnglish
Pages (from-to)e1236-e1242
JournalActa Ophthalmologica
Issue number7
Early online date11 Feb 2021
Publication statusPublished - Nov 2021

Bibliographical note

© 2021 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.


  • Adult
  • Blood Pressure/physiology
  • Body Mass Index
  • Cardiovascular Diseases/epidemiology
  • Dry Eye Syndromes/complications
  • Female
  • Humans
  • Male
  • Microcirculation/physiology
  • Middle Aged
  • Prevalence
  • Retinal Vessels/physiopathology
  • Risk Assessment/methods
  • Risk Factors
  • United Kingdom/epidemiology


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