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Associated morbidity of nasolacrimal duct obstruction—a large community based case–control study

  • Oculoplastics and Orbit
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Abstract

Background

To evaluate the prevalence and risk factors of various conditions among patients with nasolacrimal duct obstruction (NLDO).

Methods

A retrospective, observational case control study of 2,615 patients diagnosed with NLDO in the Central District of Clalit Health Services HMO in Israel, from 2003 to 2012; 15,650 control patients were randomly selected from the district HMO members. Medical and socio-demographic information were extracted from patients’ electronic medical records. The prevalence of various ocular and systemic conditions as risk factors for NLDO was calculated.

Results

The average age of NLDO patients was 68.3 ± 14.9 years, 34.4 % were male. Age (p < 0.001), ischemic heart disease (OR = 1.29; CI: 1.15–1.44), glaucoma (OR = 1.17; CI: 1.01–1.36), allergic conjunctivitis (OR = 3.59; CI: 3.28–3.94), dry eye (OR = 1.43; CI: 1.31–1.58), epiphora (OR = 6.34; CI: 5.09–7.91), and allergic rhinitis (OR = 1.51; CI: 1.33–1.71) were significantly associated with NLDO. Smoking (OR = 0.86; CI: 0.77–0.96) was significantly less prevalent among NLDO patients.

Conclusions

The etiology of NLDO is multifactorial. The prevalence of associated demographic, systemic, and periocular conditions varies. A better understanding of the patho-physiological association between these factors and NLDO may help its prevention and treatment.

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References

  1. Woog JJ (2007) The incidence of symptomatic acquired lacrimal outflow obstruction among residents of Olmsted County, Minnesota, 1976–2000 (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc 105:649–666

    PubMed Central  PubMed  Google Scholar 

  2. Linberg JV, McCormick SA (1986) Primary acquired nasolacrimal duct obstruction. A clinicopathologic report and biopsy technique. Ophthalmology 93:1055–1063

    Article  CAS  PubMed  Google Scholar 

  3. Seider N, Miller B, Beiran I (2008) Topical glaucoma therapy as a risk factor for nasolacrimal duct obstruction. Am J Ophthalmol 145:120–123

    Article  CAS  PubMed  Google Scholar 

  4. McNab AA (1998) Lacrimal canalicular obstruction associated with topical ocular medication. Aust N Z J Ophthalmol 26:219–223

    Article  CAS  PubMed  Google Scholar 

  5. Kashkouli MB, Rezaee R, Nilforoushan N, Salimi S, Foroutan A, Naseripour M (2008) Topical antiglaucoma medications and lacrimal drainage system obstruction. Ophthal Plast Reconstr Surg 24:172–175

    Article  PubMed  Google Scholar 

  6. Tucker N, Chow D, Stockl F, Codere F, Burnier M (1997) Clinically suspected primary acquired nasolacrimal duct obstruction: clinicopathologic review of 150 patients. Ophthalmology 104:1882–1886

    Article  CAS  PubMed  Google Scholar 

  7. Lee-Wing MW, Ashenhurst ME (2001) Clinicopathologic analysis of 166 patients with primary acquired nasolacrimal duct obstruction. Ophthalmology 108:2038–2040

    Article  CAS  PubMed  Google Scholar 

  8. Pisella PJ, Pouliquen P, Baudouin C (2002) Prevalence of ocular symptoms and signs with preserved and preservative free glaucoma medication. Br J Ophthalmol 86:418–423

    Article  CAS  PubMed  Google Scholar 

  9. Schwab IR, Linberg JV, Gioia VM, Benson WH, Chao GM (1992) Foreshortening of the inferior conjunctival fornix associated with chronic glaucoma medications. Ophthalmology 99:197–202

    Article  CAS  PubMed  Google Scholar 

  10. Rennert G, Peterburg Y (2001) Prevalence of selected chronic diseases in Israel. Isr Med Assoc J 3:404–408

    CAS  PubMed  Google Scholar 

  11. Twardella D, Loew M, Rothenbacher D, Stegmaier C, Ziegler H, Brenner H (2006) The diagnosis of a smoking-related disease is a prominent trigger for smoking cessation in a retrospective cohort study. J Clin Epidemiol 59:82–89

    Article  PubMed  Google Scholar 

  12. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ (2003) The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 289:2560–2572

    Article  CAS  PubMed  Google Scholar 

  13. Conroy RM, Pyorala K, Fitzgerald AP, Sans S, Menotti A, De Backer G, De Bacquer D, Ducimetiere P, Jousilahti P, Keil U, Njolstad I, Oganov RG, Thomsen T, Tunstall-Pedoe H, Tverdal A, Wedel H, Whincup P, Wilhelmsen L, Graham IM (2003) Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 24:987–1003

    Article  CAS  PubMed  Google Scholar 

  14. Alberti KG, Zimmet PZ (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 15:539–553

    Article  CAS  PubMed  Google Scholar 

  15. Dalgleish R (1967) Idiopathic acquired lacrimal drainage obstruction. Br J Ophthalmol 51:463–468

    Article  CAS  PubMed  Google Scholar 

  16. Mills DM, Meyer DR (2006) Acquired nasolacrimal duct obstruction. Otolaryngol Clin North Am 39:979–999

    Article  PubMed  Google Scholar 

  17. Bartley GB (1992) Acquired lacrimal drainage obstruction: an etiologic classification system, case reports, and a review of the literature. Part 1. Ophthal Plast Reconstr Surg 8:237–242

    Article  CAS  PubMed  Google Scholar 

  18. Bartley GB (1992) Acquired lacrimal drainage obstruction: an etiologic classification system, case reports, and a review of the literature. Part 2. Ophthal Plast Reconstr Surg 8:243–249

    Article  CAS  PubMed  Google Scholar 

  19. Bartley GB (1993) Acquired lacrimal drainage obstruction: an etiologic classification system, case reports, and a review of the literature. Part 3. Ophthal Plast Reconstr Surg 9:11–26

    Article  CAS  PubMed  Google Scholar 

  20. Janssen AG, Mansour K, Bos JJ, Castelijns JA (2001) Diameter of the bony lacrimal canal: normal values and values related to nasolacrimal duct obstruction: assessment with CT. AJNR Am J Neuroradiol 22:845–850

    CAS  PubMed  Google Scholar 

  21. Groessl SA, Sires BS, Lemke BN (1997) An anatomical basis for primary acquired nasolacrimal duct obstruction. Arch Ophthalmol 115:71–74

    Article  CAS  PubMed  Google Scholar 

  22. Zolli CL, Shannon GM (1982) Dacryocystorhinostomy: a review of 119 cases. Ophthalmic Surg 13:905–910

    CAS  PubMed  Google Scholar 

  23. Sherwood MB, Grierson I, Millar L, Hitchings RA (1989) Long-term morphologic effects of antiglaucoma drugs on the conjunctiva and Tenon’s capsule in glaucomatous patients. Ophthalmology 96:327–335

    Article  CAS  PubMed  Google Scholar 

  24. Brandt JD, Wittpenn JR, Katz LJ, Steinmann WN, Spaeth GL (1991) Conjunctival impression cytology in patients with glaucoma using long-term topical medication. Am J Ophthalmol 112:297–301

    CAS  PubMed  Google Scholar 

  25. Narioka J, Ohashi Y (2007) Effects of beta-adrenergic antagonist on width of nasolacrimal drainage system lumen. J Ocul Pharmacol Ther 23:467–475. doi:10.1089/jop.2007.0025

    Article  CAS  PubMed  Google Scholar 

  26. Narioka J, Ohashi Y (2007) Effects of adrenergic and cholinergic antagonists on diameter of nasolacrimal drainage system. Graefes Arch Clin Exp Ophthalmol 245:1843–1850

    Article  CAS  PubMed  Google Scholar 

  27. Barkana Y, Harris A, Hefez L, Zaritski M, Chen D, Avni I (2003) Unrecordable pulsatile ocular blood flow may signify severe stenosis of the ipsilateral internal carotid artery. Br J Ophthalmol 87:1478–1480

    Article  CAS  PubMed  Google Scholar 

  28. Patterson JW (1955) Effect of blood supply on the development of cataracts. Am J Physiol 180:495–497

    CAS  PubMed  Google Scholar 

  29. Ramdas WD, Wolfs RC, Hofman A, de Jong PT, Vingerling JR, Jansonius NM (2011) Lifestyle and risk of developing open-angle glaucoma: the Rotterdam study. Arch Ophthalmol 129:767–772

    Article  PubMed  Google Scholar 

  30. Jones LT (1965) Tear-sac foreign bodies. Am J Ophthalmol 60:111–113

    CAS  PubMed  Google Scholar 

  31. Kashkouli MB, Sadeghipour A, Kaghazkanani R, Bayat A, Pakdel F, Aghai GH (2010) Pathogenesis of primary acquired nasolacrimal duct obstruction. Orbit 29:11–15

    Article  PubMed  Google Scholar 

  32. Luthra R, Nemesure BB, Wu SY, Xie SH, Leske MC (2001) Frequency and risk factors for pterygium in the Barbados Eye Study. Arch Ophthalmol 119:1827–1832

    Article  CAS  PubMed  Google Scholar 

  33. McCarty CA, Fu CL, Taylor HR (2000) Epidemiology of pterygium in Victoria, Australia. Br J Ophthalmol 84:289–292

    Article  CAS  PubMed  Google Scholar 

  34. West S, Munoz B (2009) Prevalence of pterygium in Latinos: Proyecto VER. Br J Ophthalmol 93:1287–1290

    Article  CAS  PubMed  Google Scholar 

  35. Michaud SE, Menard C, Guy LG, Gennaro G, Rivard A (2003) Inhibition of hypoxia-induced angiogenesis by cigarette smoke exposure: impairment of the HIF-1alpha/VEGF pathway. FASEB J 17:1150–1152

    CAS  PubMed  Google Scholar 

  36. Motejlek K, Palluch F, Neulen J, Grummer R (2006) Smoking impairs angiogenesis during maturation of human oocytes. Fertil Steril 86:186–191

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

Financial support

None.

Financial disclosures

The authors have no financial interest in any of the materials used in this study.

Dr Arie Nemet had full access to all study data, and takes responsibility for the integrity of the data and the accuracy of the data analysis. The statistical analysis was performed by Mrs. Nava Yelin, statistician. The manuscript was edited by Mrs Faye Schreiber.

Both authors have read and approved the manuscript.

Conflict of interest

No conflicting relationship exists for any author.

Funding

None.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Meir Medical Center, Kfar Saba, 44281, Israel

    Arie Y. Nemet

  2. Central Headquarters, Clalit Health Services, Tel Aviv, Israel

    Shlomo Vinker

  3. Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Shlomo Vinker

Authors
  1. Arie Y. Nemet
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  2. Shlomo Vinker
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Correspondence to Arie Y. Nemet.

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Nemet, A.Y., Vinker, S. Associated morbidity of nasolacrimal duct obstruction—a large community based case–control study. Graefes Arch Clin Exp Ophthalmol 252, 125–130 (2014). https://doi.org/10.1007/s00417-013-2484-3

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  • DOI: https://doi.org/10.1007/s00417-013-2484-3

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