Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Eye (Lond). 2023 Nov;37(16):3484-3491. doi: 10.1038/s41433-023-02538-4. Epub 2023 Apr 15.
BACKGROUND/OBJECTIVE: To test the feasibility of a dry eye disease (DED) symptom stratification algorithm previously established for the general population among patients visiting ophthalmologists. SUBJECT/METHODS: This retrospective cross-sectional study was conducted between December 2015 and October 2021 at a university hospital in Japan; participants who underwent a comprehensive DED examination and completed the Japanese version of the Ocular Surface Disease Index (J-OSDI) were included. Patients diagnosed with DED were stratified into seven clusters using a previously established symptom-based stratification algorithm for DED. Characteristics of the patients in stratified clusters were compared. RESULTS: In total, 426 participants were included (median age [interquartile range]; 63 [48-72] years; 357 (83.8%) women). Among them, 291 (68.3%) participants were diagnosed with DED and successfully stratified into seven clusters. The J-OSDI total score was highest in cluster 1 (61.4 [52.2-75.0]), followed by cluster 5 (44.1 [38.8-47.9]). The tear film breakup time was the shortest in cluster 1 (1.5 [1.1-2.1]), followed by cluster 3 (1.6 [1.0-2.5]). The J-OSDI total scores from the stratified clusters in this study and those from the clusters identified in the previous study showed a significant correlation (r = 0.991, P < 0.001). CONCLUSIONS: The patients with DED who visited ophthalmologists were successfully stratified by the previously established algorithm for the general population, uncovering patterns for their seemingly heterogeneous and variable clinical characteristics of DED. The results have important implications for promoting treatment interventions tailored to individual patients and implementing smartphone-based clinical data collection in the future.
背景/目的:在眼科就诊的患者中测试先前为一般人群建立的干眼症(DED)症状分层算法的可行性。
方法:这是一项回顾性横断面研究,于 2015 年 12 月至 2021 年 10 月在日本的一所大学医院进行;纳入接受全面 DED 检查并完成日本版眼表疾病指数(J-OSDI)的患者。使用先前建立的基于症状的 DED 分层算法,将诊断为 DED 的患者分为七个聚类。比较分层聚类患者的特征。
结果:共纳入 426 名参与者(中位数[四分位数范围];63[48-72]岁;357[83.8%]为女性)。其中,291 名(68.3%)参与者被诊断为 DED 并成功分为七个聚类。J-OSDI 总分为 1 分(61.4[52.2-75.0]),其次是 5 分(44.1[38.8-47.9])。泪膜破裂时间最短的是 1 分(1.5[1.1-2.1]),其次是 3 分(1.6[1.0-2.5])。本研究中分层聚类的 J-OSDI 总分与先前研究中确定的聚类具有显著相关性(r=0.991,P<0.001)。
结论:在眼科就诊的 DED 患者可成功按照先前为一般人群建立的算法进行分层,揭示其看似异质和可变的 DED 临床特征模式。研究结果对未来促进针对个体患者的治疗干预和实施基于智能手机的临床数据收集具有重要意义。
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