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2024 OMIG Abstract

Comparison of Pain Interference on Quality of Life in Neuropathic Corneal Pain (NCP) and Dry Eye Disease (DED) Patients with and without Non-ocular Facial Pain

Leyla Mirzaee, Akhil Mekka, Maria J. Lopez, Gabriela Dieckmann, N. Dilruba Koseoglu, Arsia Jamali, Stephanie M. Cox, Pedram Hamrah

Center for Translational Ocular Immunology and Cornea Service, New England Eye Center Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA

Purpose: Neuropathic corneal pain (NCP) is caused by damage or disease of the somatosensory nervous system and presents with symptoms of pain, burning, dryness, or light sensitivity. NCP can be caused by infections, including herpes simplex keratitis, herpes zoster ophthalmicus, and other types of microbial keratitis, as well as systemic infectious, such as lyme disease. The aims of this study are to compare the perception of ocular pain in patients with NCP and DED, to measure its impact on quality of life (QoL) dimensions (physical, psychological, social), and to compare results in NCP patients with minimal to those with moderate/severe facial pain.

Methods: A retrospective, cross-sectional study, comparative study was conducted, including NCP (N=65) and DED (N=100) patients. The NCP group included patients with none to mild non-ocular pain (group 1; score 0-3/10; n=25) and patients with moderate/severe non-ocular pain (group 2; score 4-10/10; n=40). Demographic features, ocular pain assessment survey (OPAS), and ocular surface disease index (OSDI) scores were reviewed. The OPAS comprises physical (vision-related), social and psychological dimensions of QoL through six items.

Results: The mean age and sex between of DED and NCP were not statistically significant. The mean pain scores (scale 0-10) in the last 24 hours were 2.04±2.68 in DED patients and 5.03±3.22 in NCP (p< 0.01) respectively. The interference of pain on QoL for DED and NCP patients was: reading/computer (DED 3.33±3.24, NCP 5.54±3.46, p=0.003), driving/TV (DED 3.08±3.28, NCP 4.59±3.32, p=0.024) for physical (visual related) dimension and Gen Act (DED 2.04±2.77, NCP 3.87±3.04, p=0.001); Mood (DED 3.04±3.39, NCP 5.66±3.48 p=0.001); Sleep (DED 2.32±3.28, NCP 3.46±3.18, p=0.014) for the psychological dimension; enjoying life/social relations (DED 2.80±3.26, NCP 5.15±3.50, p=0.001) for the social dimension of QoL. While pain had no significant impact on the visual dimension of QoL in DED (R=0.14; p=0.25), it had a significant impact in NCP patients (R=0.41; p=0.001). No significant difference in gender was resulting in any QoL dimension (p> 0.05). Group 1 NCP patients reported 1.08±0.23 non-ocular pain in the last 2 weeks and group 2 patients reported 7.0±0.36 (p<0.0001). The interference of pain on all QoL dimensions was not significant between both NCP groups (p> 0.05) except for the item sleep (p=0.04).

Conclusions: Pain in patients with NCP has a more pronounced interference with all dimensions of QoL as compared to DED. Ocular pain perception in NCP patients with minimal or moderate/severe non-ocular facial pain is comparable, demonstrating that NCP alone, even without non-ocular facial pain, significantly impacts all QoL dimensions.


Disclosure:

N (LM, AM, ML, GD, DK, AJ, SC); C (PH, Novartis, Oysterpoint Pharma, OKYO)