Abstract
BackgroundTo determine whether quality of life (QOL) and health utility are affected to the same extent among dry eye (DE) patients with short tear film break-up time dry eye (TBUT-DE) with minimal clinical signs were as severe as aqueous-deficient dry eye (ADDE).MethodsA multicenter cross-sectional study was conducted among DE patients who visited one of 10 eye clinics in Japan. Among the 463 registered patients, this study involved 449 patients with DE who were aged 20 years or older. Ophthalmic examination findings were assessed, including tear film break-up time (TBUT), Schirmer I value, and keratoconjunctival staining score. QOL was evaluated with the Dry Eye-Related Quality-of-Life Score (DEQS; 0 [best], 100 [worst]) and health utility (1 [total health], 0 [worst]) with the Health Utilities Index Mark 3 (HUI-3); scores were stratified by DE subgroup.ResultsMedian (interquartile range) of DEQS and HUI-3 scores across all participants were 21.7 (10.0–40.0) and 0.82 (0.69–0.91), respectively. Median (interquartile range) DEQS and HUI-3 scores in the ADDE group were 23.3 (10.0–40.0) and 0.79 (0.69–0.88), respectively; those in the short TBUT-DE group were 23.3 (13.3–38.3) and 0.82 (0.74–0.92), respectively. There were no significant between-group differences in questionnaire scores. Among the ophthalmic examination findings, a weak significant correlation between TBUT, corneal staining score and keratoconjunctival staining score to DEQS; TBUT and Schirmer test values to HUI-3, were seen.ConclusionsThe burden of short TBUT-DE on QOL as assessed by the DEQS and HUI-3 was as severe as that in ADDE. Our findings suggest that clinicians should be aware of the impact of short TBUT-DE on patients QOL and utility values.Trial registrationUniversity Hospital Medical Information Network (registration no. UMIN 000015890). Registered 10th December 2014, retrospectively registered.
Highlights
To determine whether quality of life (QOL) and health utility are affected to the same extent among dry eye (DE) patients with short tear film break-up time dry eye (TBUT-DE) with minimal clinical signs were as severe as aqueous-deficient dry eye (ADDE)
Study populations A total of 463 eligible patients (45–50 per study site) were initially consented and 14 patients were excluded; 9 patients did not meet the criteria for diagnosis of dry eye disease (DED), 3 patients were under 20 years of age and 2 patients drew consent
The DE subtypes of 140 patients, those who were other than ADDE and short TBUT-DE include Sjögren syndrome, contact-lens related DE, meibomian gland dysfunction (MGD), 463 patients from 10 study sites enrolled in Dry Eye CrossSectional Study in Japan (DECS-J)
Summary
To determine whether quality of life (QOL) and health utility are affected to the same extent among dry eye (DE) patients with short tear film break-up time dry eye (TBUT-DE) with minimal clinical signs were as severe as aqueous-deficient dry eye (ADDE). The most common ocular symptoms of DED are discomfort and visual disturbance [2], including dryness, grittiness, ocular fatigue, redness, foreign body sensation, and soreness [6, 11] These symptoms are known to reduce patients’ perception of their quality of life (QOL) [12, 13] and utility values [14, 15], which have identified a number of DE subtypes, including aqueous-deficient dry eye (ADDE) and short tear film break-up time dry eye (short TBUT-DE). In 2017, the epidemiological results of Dry Eye Cross-Sectional Study (DECS-J) revealed that the two most common DED subtypes were ADDE and short TBUT-DE [7]. These findings led us to speculate about whether the disease burden of DE subtypes (ADDE and short TBUT-DE) had a similar effect on QOL
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