Diagnostic ability of maximum blink interval together with Japanese version of Ocular Surface Disease Index score for dry eye disease

Kunihiko Hirosawa,Ken Nagino,Yasutsugu Akasaki,Akie Midorikawa-Inomata,Jaemyoung Sung,Hurramhon Shokirova,Jun Zhu,Masahiro Nakamura,Takenori Inomata,Ai Yanagawa,Maria Miura,Atsuko Eguchi,Akira Murakami,Keiichi Fujimoto,Kenta Fujio,Mizu Kuwahara,Yuichi Okumura

doi:10.1038/s41598-020-75193-4

Kunihiko Hirosawa, Ken Nagino + Show 15 more

Open Access

https://doi.org/10.1038/s41598-020-75193-4

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Abstract

Various symptoms of the dry eye disease (DED) interfere with the quality of life and reduce work productivity. Therefore, screening, prevention, and treatment of DED are important. We aimed to investigate the potential diagnostic ability of the maximum blink interval (MBI) (the length of time participants could keep their eyes open) with disease-specific questionnaire for DED. This cross-sectional study included 365 patients (252 with DED and 113 without DED) recruited between September 2017 and December 2019. Discriminant validity was assessed by comparing the non-DED and DED groups based on the MBI with a Japanese version of the Ocular Surface Disease Index (J-OSDI) and tear film breakup time (TFBUT) with J-OSDI classifications. The MBI with J-OSDI showed good discriminant validity by known-group comparisons. The positive and predictive values of MBI with J-OSDI were 96.0% (190/198 individuals) and 37.1% (62/167 individuals), respectively. The area under the receiver operating characteristic curve (AUC) of MBI with J-OSDI was 0.938 (95% confidence interval 0.904–0.971), the sensitivity was 75.4% (190/252 individuals), and the specificity was 92.9% (105/113 individuals), which are similar to the diagnostic ability of TFBUT with J-OSDI (AUC 0.954). In conclusion, MBI with J-OSDI may be a simple, non-invasive screening test for DED.

Highlights

Dry eye disease (DED) is one of the most common eye diseases, affecting 5–50% of the population worldwide[1]
The diagnostic criteria of dry eye disease (DED) based on the Tear Film and Ocular Surface Society and Asia Dry Eye Society (ADES) share subjective symptoms and lower tear film breakup time (TFBUT) as the primary DED test, and if TFBUT can be replaced by maximum blink interval (MBI), a remote diagnosis and self-monitoring app using disease-specific questionnaire, such as the Ocular Surface Disease Index (OSDI)[22] and MBI, may be possible
As MBI and J-OSDI are both non-invasive, simple methods of testing DED, their combinatory usage might be a great tool for healthcare providers as well as useful for individuals with undiagnosed DED during initial triage

Summary

Introduction

Dry eye disease (DED) is one of the most common eye diseases, affecting 5–50% of the population worldwide[1]. The elderly, and young people are expected to suffer more from DED due to the increase in digital work associated with the advent of computers and s martphones[4,5] In this context, developing a simple screening and self-check method for DED is important for self-management of the disease. The diagnostic criteria of DED based on the Tear Film and Ocular Surface Society and ADES share subjective symptoms and lower TFBUT as the primary DED test, and if TFBUT can be replaced by MBI, a remote diagnosis and self-monitoring app using disease-specific questionnaire, such as the Ocular Surface Disease Index (OSDI)[22] and MBI, may be possible.

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