Department of Optics, Laboratory of Vision Sciences and Applications, University of Granada, Granada, Spain.
TACIR Clinic, Teknon Medical Centre (Quirón Salud Group), Barcelona, Spain.
Ophthalmic Physiol Opt. 2024 Nov;44(7):1472-1483. doi: 10.1111/opo.13373. Epub 2024 Aug 2.
To evaluate signs and symptoms in patients diagnosed with dry eye disease (DED), divided into dry eye (DE) groups, in order to find a new biomarker that allows an accurate diagnosis, management and classification of DED.
This cross-sectional, observational study included 71 DED subjects. Subjective symptoms, visual quality and DE signs were assessed using the Ocular Surface Disease Index (OSDI), the Quality of Vision (QoV) questionnaire, best corrected distance visual acuity (VA), functional visual acuity (FVA), contrast sensitivity (CS), high- and low-order corneal aberrations (HOA and LOA, respectively), tear break-up time (TBUT), Meibomian Gland Dysfunction (MGD), Schirmer test, corneal staining, lid wiper epitheliopathy (LWE) and meibography. Participants were classified into three groups based on dryness severity using a cluster analysis, i.e., mild (N = 17, 55.8 ± 15.4 years), moderate (N = 41, 63.5 ± 10.6 years) and severe (N = 13, 65.0 ± 12.0). A new Dry Eye Severity Index (DESI) based on ocular surface signs has been developed and its association with symptoms, visual quality and signs was assessed. Comparisons between groups were made using Kruskal-Wallis and Chi-squared tests. Spearman correlation analysis was also performed.
The DESI was based on three tests for DE signs: TBUT, Schirmer test and MGD. The DESI showed significant differences between different pairs of groups: Mild Dryness versus Moderate Dryness (p < 0.001), Mild Dryness versus Severe Dryness (p < 0.001) and Moderate Dryness versus Severe Dryness (p < 0.001). The DESI was significantly correlated with age (rho = -0.30; p = 0.01), OSDI score (rho = -0.32; p = 0.007), QoV score (rho = -0.35; p = 0.003), VA (rho = -0.34; p = 0.003), FVA (rho = -0.38; p = 0.001) and CS (rho = 0.42; p < 0.001) Also, significant differences between the severity groups were found for OSDI and QoV scores, VA, FVA, CS and MGD (p < 0.05).
The DESI has good performance as a biomarker for the diagnosis, classification and management of DED.
评估诊断为干眼（DED）患者的症状和体征，分为干眼（DE）组，以寻找一种新的生物标志物，实现 DED 的准确诊断、管理和分类。
这是一项横断面、观察性研究，共纳入 71 例 DED 患者。使用眼表疾病指数（OSDI）、视觉质量问卷（QoV）、最佳矫正远视力（VA）、功能性远视力（FVA）、对比敏感度（CS）、高阶和低阶角膜像差（HOA 和 LOA）、泪膜破裂时间（TBUT）、睑板腺功能障碍（MGD）、Schirmer 试验、角膜染色、眼裂斑上皮病变（LWE）和睑板腺照相评估主观症状、视觉质量和 DE 体征。使用聚类分析将参与者分为三组，根据干燥严重程度进行分类，即轻度（N=17，55.8±15.4 岁）、中度（N=41，63.5±10.6 岁）和重度（N=13，65.0±12.0 岁）。根据眼部表面体征开发了一种新的干眼严重程度指数（DESI），并评估了其与症状、视觉质量和体征的相关性。使用 Kruskal-Wallis 和卡方检验比较组间差异。还进行了 Spearman 相关分析。
DESI 基于三个 DE 体征测试：TBUT、Schirmer 试验和 MGD。DESI 在不同组间的差异有统计学意义：轻度干燥与中度干燥（p<0.001）、轻度干燥与重度干燥（p<0.001）、中度干燥与重度干燥（p<0.001）。DESI 与年龄（rho=-0.30；p=0.01）、OSDI 评分（rho=-0.32；p=0.007）、QoV 评分（rho=-0.35；p=0.003）、VA（rho=-0.34；p=0.003）、FVA（rho=-0.38；p=0.001）和 CS（rho=0.42；p<0.001）显著相关。此外，OSDI 和 QoV 评分、VA、FVA、CS 和 MGD 在严重程度组间也有显著差异（p<0.05）。
DESI 作为 DED 的诊断、分类和管理的生物标志物具有良好的性能。
