Al-Zubi Khalid M, Al-Kubaisy Waqar A, Al-Azzeh Yazan E, Batayneh Batool K, Alqaraleh Hazim A, Abid Lo'ay A, Al-Jadid Al-Majali Ghazi O, Alhajaj Noor T
Department of Ophthalmology, Faculty of Medicine, Mu'tah University, Mu'tah, Jordan.
Department of Epidemiology, Faculty of Medicine, Mu'tah University, Mu'tah, Jordan.
Med Hypothesis Discov Innov Ophthalmol. 2023 Dec 31;12(2):70-77. doi: 10.51329/mehdiophthal1472. eCollection 2023 Summer.
Dry eye disease (DED) is a multifactorial condition often characterized by a reduction in tear film quantity or quality. This study aimed to determine the frequency of DED and its associated subjective symptoms among students of Mu'tah University.
In this cross-sectional study conducted at Mu'tah University, Mu'tah, Jordan, from January to April 2022, 489 students completed an online patient-reported DED symptom questionnaire and the ocular surface disease index (OSDI) questionnaire. Moreover, 106 participants underwent clinical examinations using the Schirmer test I and fluorescein tear breakup time (TBUT).
Approximately 74.6% of the students self-reported experiencing DED symptoms, and 72.6% had an OSDI score > 12, which is considered the threshold for an abnormal ocular surface. Clinical examinations revealed low Schirmer test scores ( < 10 mm) in 26.4% (n = 28) and 25.5% (n = 27) of the right and left eyes, respectively. We observed low TBUT scores ( < 5 s) in 19.8% (n = 21) and 18.9% (n = 20) of the right and left eyes, respectively. We noted significant differences between the self-reported DED symptoms and the Schirmer test scores ( = 0.003 for both right and left eyes), TBUT ( < 0.001 for both right and left eyes), and OSDI score ( < 0.001 for each self-reported DED symptom). We observed a weak significant positive correlation between Schirmer test scores and TBUT in the right (r = + 0.30; = 0.002) and left (r = + 0.34; < 0.001) eyes; a negligible significant inverse correlation between OSDI scores and Schirmer test scores in the right (r = - 0.24; = 0.013) and left (r = - 0.23; = 0.019) eyes; and a negligible significant inverse correlation between the OSDI score and TBUT of the left eye (r = - 0.25; = 0.011) but not of the right eye (r = - 0.17; = 0.077).
The frequency of DED symptoms in this study was higher than that previously reported based on foreign statistics. The presence of self-reported DED symptoms was significantly associated with higher OSDI scores. Self-reported DED symptoms were more frequent than the abnormalities detected using objective methods. Therefore, a combination of subjective and objective measures may provide higher diagnostic yield for DED. Further studies are required to confirm this hypothesis.
干眼症（DED）是一种多因素疾病，通常表现为泪膜数量或质量下降。本研究旨在确定穆塔大学学生中干眼症的发生率及其相关主观症状。
在2022年1月至4月于约旦穆塔的穆塔大学进行的这项横断面研究中，489名学生完成了一份在线患者报告的干眼症症状问卷和眼表疾病指数（OSDI）问卷。此外，106名参与者接受了使用I型泪液分泌试验和荧光素泪膜破裂时间（TBUT）的临床检查。
约74.6%的学生自我报告有干眼症症状，72.6%的学生OSDI评分>12，这被认为是眼表异常的阈值。临床检查显示，右眼和左眼分别有26.4%（n = 28）和25.5%（n = 27）的泪液分泌试验得分低（<10 mm）。我们观察到，右眼和左眼分别有19.8%（n = 21）和18.9%（n = 20）的TBUT得分低（<5秒）。我们注意到自我报告的干眼症症状与泪液分泌试验得分（右眼和左眼均为P = 0.003）、TBUT（右眼和左眼均为P<0.001）以及OSDI评分（每种自我报告的干眼症症状的P<0.001）之间存在显著差异。我们观察到，右眼（r = +0.30；P = 0.002）和左眼（r = +0.34；P<0.001）的泪液分泌试验得分与TBUT之间存在弱的显著正相关；右眼（r = -0.24；P = 0.013）和左眼（r = -0.23；P = 0.019）的OSDI评分与泪液分泌试验得分之间存在可忽略不计的显著负相关；左眼的OSDI评分与TBUT之间存在可忽略不计的显著负相关（r = -0.25；P = 0.011），但右眼不存在（r = -0.17；P = 0.077）。
本研究中干眼症症状的发生率高于此前基于国外统计数据报告的发生率。自我报告的干眼症症状与较高的OSDI评分显著相关。自我报告的干眼症症状比使用客观方法检测到的异常更为常见。因此，主观和客观测量方法相结合可能会提高干眼症的诊断率。需要进一步的研究来证实这一假设。
