Mazyar Yazdani1,2, Xiangjun Chen2,3,4,5,6, Behzod Tashbayev2,4, Øygunn A Utheim1,2, Sten Ræder2, Yanjun Hua7, Jon R Eidet8, Aleksandar Stojanovic9, Darlene A Dartt10, Tor P Utheim1,2,3,4,5,6,11,12,13,14. 1. Department of Medical Biochemistry, Oslo University Hospital , Oslo , Norway. 2. The Norwegian Dry Eye Clinic , Oslo , Norway. 3. Department of Ophthalmology, Arendal Hospital , Arendal , Norway. 4. Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo , Oslo , Norway. 5. Faculty of Health Sciences, National Centre for Optics, Vision and Eye Care, University College of Southeast Norway , Kongsberg , Norway. 6. Department of Ophthalmology, Vestre Viken Hospital Trust , Drammen , Norway. 7. Department of Ophthalmology, Shanghai Jiaotong University affiliated Sixth People's Hospital , Shanghai , China. 8. Department of Ophthalmology, Oslo University Hospital , Oslo , Norway. 9. Department of ophthalmology, University Hospital North Norway , Tromsø , Norway. 10. Schepens Eye Research Institute/Massachusetts Eye and Ear, Harvard Medical School , Boston , MA , USA. 11. Department of Plastic and Reconstructive Surgery, Oslo University Hospital , Oslo , Norway. 12. Department of maxillofacial surgery, Oslo University Hospital , Oslo , Norway. 13. Department of Ophthalmology, Stavanger University Hospital , Stavanger , Norway. 14. Department of Clinical Medicine, Faculty of Medicine, University of Bergen , Bergen , Norway.
Abstract
Purpose: To investigate to what extent the OSDI can be utilized as a discriminative test for clinical findings. Methods: One thousand and ninety patients with dry eye disease (DED) were consecutively included and examined for osmolarity, tear film break-up time (TFBUT), ocular protection index (OPI), ocular surface staining (OSS), Schirmer I test (ST), meibum expressibility (ME), meibum quality (MQ), and diagnosis of meibomian gland dysfunction (MGD). Receiver-operating characteristic curve (ROC) analysis considering optimum balanced sensitivity and specificity (close to 50%) was used for assessment. Results: The present study on more than 1,000 patients indicates that the OSDI in the ROC curve analysis is a poor discriminator of pathological scores for TFBUT ≤ 5 (AUC = 0.553; p = .012) and ≤10 s (AUC = 0.608; p = .002), OSS ≥ 3 (AUC = 0.54; p = .043), ST ≤ 5 (AUC = 0.550; p = .032) and ≤10 mm/5 min (AUC = 0.544; p = .016), and ME ≥ 1 (AUC = 0.594; p = <0.001). Pathological scores for osmolarity >308 and >316 mOsm/L, OPI, OSS > 1, MQ, and MGD could not be discriminated by OSDI (p > .05). Conclusion: Cut-off values for the OSDI can be defined to discriminate pathological TFBUT (≤5 and ≤10), OSS (≥3), ST (≤5 and ≤10) and ME, however, the discriminability was low. Our comprehensive study emphasises the importance of taking both symptoms and signs into account in DED management.
Purpose: To investigate to what extent the OSDI can be utilized as a discriminative test for clinical findings. Methods: One thousand and ninety patients with dry eye disease (DED) were consecutively included and examined for osmolarity, tear film break-up time (TFBUT), ocular protection index (OPI), ocular surface staining (OSS), Schirmer I test (ST), meibum expressibility (ME), meibum quality (MQ), and diagnosis of meibomian gland dysfunction (MGD). Receiver-operating characteristic curve (ROC) analysis considering optimum balanced sensitivity and specificity (close to 50%) was used for assessment. Results: The present study on more than 1,000 patients indicates that the OSDI in the ROC curve analysis is a poor discriminator of pathological scores for TFBUT ≤ 5 (AUC = 0.553; p = .012) and ≤10 s (AUC = 0.608; p = .002), OSS ≥ 3 (AUC = 0.54; p = .043), ST ≤ 5 (AUC = 0.550; p = .032) and ≤10 mm/5 min (AUC = 0.544; p = .016), and ME ≥ 1 (AUC = 0.594; p = <0.001). Pathological scores for osmolarity >308 and >316 mOsm/L, OPI, OSS > 1, MQ, and MGD could not be discriminated by OSDI (p > .05). Conclusion: Cut-off values for the OSDI can be defined to discriminate pathological TFBUT (≤5 and ≤10), OSS (≥3), ST (≤5 and ≤10) and ME, however, the discriminability was low. Our comprehensive study emphasises the importance of taking both symptoms and signs into account in DED management.
Authors: Jerry R Paugh; Elaine Chen; Justin Kwan; Tiffany Nguyen; Alan Sasai; Melinda Thomas De Jesus; Andrew Loc Nguyen; Michael T Christensen; David Meadows Journal: Transl Vis Sci Technol Date: 2022-02-01 Impact factor: 3.283