Scientific Reports (Mar 2021)

Ocular manifestations and biomarkers of Gulf War Illness in US veterans

  • Brandon S. Baksh,
  • Kristen L. Zayan,
  • Raquel Goldhardt,
  • Elizabeth R. Felix,
  • Nancy Klimas,
  • Anat Galor

DOI
https://doi.org/10.1038/s41598-021-86061-0
Journal volume & issue
Vol. 11, no. 1
pp. 1 – 8

Abstract

Read online

Abstract Gulf War Illness (GWI) is a multisystem disease with variable presentations, making diagnosis difficult. Non-invasive biomarkers would aid in disease diagnosis. We hypothesized that the eye could serve as a biomarker for GWI. We performed a retrospective case–control study using a sample of 1246 patients seen during a 5-month period in an optometry clinic. We identified veterans who were active duty during the Gulf War Era and either had a questionnaire-based diagnosis of GWI (cases) or did not (controls). Medical records were reviewed for eye and medical co-morbidities, medication use, and retinal macular and nerve fiber layer (NFL) thicknesses based on optical coherence tomography (OCT) images. Compared to controls (n = 85), individuals with GWI (n = 60) had a higher frequency of dry eye symptoms (50% vs 32.9%, p = 0.039). Multivariable analysis revealed average retinal NFL thickness (odds ratio; OR = 0.95), cup-to-disc ratio (OR = 0.005), age (OR = 0.82), and PTSD (OR = 20.5) were predictors of a GWI diagnosis. We conclude that GWI is associated with dry eye symptoms and RNFL thinning may serve as a biomarker for disease.