Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Ophthalmic Epidemiol. 2024 Jun;31(3):274-282. doi: 10.1080/09286586.2023.2248629. Epub 2023 Aug 17.
To determine the correlations among symptoms and signs of dry eye disease (DED) in the Dry Eye Assessment and Management (DREAM) study.
A total of 535 patients with moderate-to-severe DED were assessed for symptoms using the Ocular Surface Disease Index (OSDI) and four DED signs in both eyes (conjunctival lissamine green staining, corneal fluorescein staining, Schirmer's testing, and tear break-up time (TBUT)) following standardized protocols at baseline and follow-up visits (months 3, 6, and 12). Spearman correlation coefficients (rho) were calculated for correlations among symptoms and signs of DED at baseline and among changes in symptoms and signs from baseline at 12 months. The confidence intervals and p-values for correlation coefficients were calculated using a cluster bootstrapping to account for inter-eye correlation.
At baseline, OSDI total score was not correlated with signs; however, OSDI subscale score of ocular symptoms was weakly correlated with corneal staining score (rho = 0.14, p = .002) and Schirmer test score (rho = 0.11, p = .01). There were statistically significant correlations among the four signs (p < .001), with absolute correlation coefficient ranging from 0.14 (conjunctival staining score vs. TBUT) to 0.33 (conjunctival staining score vs. cornea staining score). The correlations among changes in symptoms and signs were weaker, with the highest correlation between change in conjunctival staining and corneal staining (rho = 0.21, p < .001).
Consistent with previous studies, among DREAM participants with moderate-to-severe DED at baseline, correlations of DED symptoms with signs were low and correlations among four objective signs were low to moderate. The correlations among changes in symptoms and signs were even weaker.
在干眼评估与管理（DREAM）研究中，确定干眼疾病（DED）的症状与体征之间的相关性。
共有 535 名中重度 DED 患者，按照标准化方案，在基线和随访（第 3、6 和 12 个月）时，双眼评估眼表疾病指数（OSDI）和四项 DED 体征（结膜丽丝胺绿染色、角膜荧光素染色、泪液分泌试验和泪膜破裂时间（TBUT））。采用 Spearman 相关系数（rho）计算 DED 症状与体征在基线时以及 12 个月时症状与体征变化之间的相关性。采用聚类 bootstrap 法计算相关系数的置信区间和 p 值，以考虑眼间相关性。
在基线时，OSDI 总分与体征无相关性；然而，眼症 OSDI 亚量表评分与角膜染色评分（rho=0.14，p=0.002）和泪液分泌试验评分（rho=0.11，p=0.01）呈弱相关。四项体征之间存在统计学显著相关性（p<0.001），绝对相关系数范围从 0.14（结膜染色评分与 TBUT）到 0.33（结膜染色评分与角膜染色评分）。症状和体征变化之间的相关性较弱，结膜染色变化与角膜染色变化之间的相关性最高（rho=0.21，p<0.001）。
与之前的研究一致，在基线时有中重度 DED 的 DREAM 参与者中，DED 症状与体征的相关性较低，四项客观体征之间的相关性较低到中等。症状和体征变化之间的相关性更弱。
