Correlation evaluation between questionnaire and clinical examination in dry eye

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Background There are two types of different questionnaires in dry eye diagnosis.But the associations about two questionnaires or questionnaire and clinical examination are still unclear.To effectively quantize the symptoms is helpful for a correct diagnosis of dry eye disease. Objective This survey was to evaluate the Standard Patient Evaluation of Eye Dryness (SPEED) and Ocular Surface Disease Index(OSDI) questionnaire for the diagnosis of dry eye and investigate the correlation between the clinical examinations and questionnaires. Methods A perspective cohort study was designed.Sixty-six patients were enrolled in this study.This study was approved by the Ethic Committee of Peking University First Hospital,and written informed consent was obtained from each subject before any ocular examination.SPEED-based and OSDI-based questionnaires were used to score the dry eye symptom and grouped according to severity of complains.Corneal fluorescence staining,tear film breakup time(BUT),Schirmer I test and tear film interferometry were performed in all patients.The correlations between two questionnaires scores and their association with clinical examinations were evaluated. Results The negative correlations were found between the SPEED-based score or OSDI-based score with BUT value(r=0.390,P=0.001 ;r=-0.395,P=0.001 ),but no significant correlations were seen between the SPEED-based score or OSDI-based score with Schirmer test( r=-0.081,P=0.515; r=-0.080,P=0.525)and tear film interferometry score(r=0.158,P=0.204;r=0.219,P=0.077).The BUT was significantly prolonged in mild symptom group compared with serious group(t=2.339,P=0.022),but no significant difference was seen in Schirmer Ⅰ test and tear film interferometry scores using SPEED-based questionnaire ( t =0.404,P =0.687 ; t =- 0.947,P =0.347 ) ; while the positive fluorescence staining rate between two groups was significantly different (x2 =0.164,P =0.685 ).When using OSDI-based questionnaire,significant difference in BUT was seen among mild,moderate and serious symptom groups ( F =11.871,P =0.000 ),and BUT in mild symptom group was delayed in comparison with moderat and serious groups( P=0.000,0.000).No significant differences were found in Schirmer Ⅰ test,tear film interferometry scores and fluorescence staining rate among three groups(F=1.432,P =0.246; F =2.799,P =0.068; x2 =6.026,P =0.050).SPEED score showed a positive correlation with OSDI score ( r =0.697,P =0.000 ). Conclusions Both OSDI and SPEED are effective tools for the evaluation of symptoms of dry eye.The two types of questionnaires are consistent in symptoms evaluation. Key words: Dry eye; Standard Patient Evaluation of Eye Dryness questionnaire; Ocular Surface Disease Index questionnaire; Tear film interferometry; Tear film breakup time; Fluorescence staining; Schirmer Ⅰ test