Abstract
To evaluate the correlation between changes in tear osmolarity, symptoms, and corneal fluorescein staining in patients with dry eye disease (DED). Retrospective, clinic-based cohort study. In this single-institution study, we reviewed the charts of 186 patients with DED from whom we had data on tear osmolarity, symptoms, and corneal fluorescein staining from 2 separate visits. Main outcomes included the correlation of the changes between the 2 visits for tear osmolarity (TearLab system), symptoms (Ocular Surface Disease Index), and corneal fluorescein staining (modified Oxford scheme). For tear osmolarity and corneal fluorescein staining the scores from the eye with highest readings were analyzed. The correlations were repeated on subgroups based on proposed cutoffs for DED severity and on patients' treatment. We found a modest, though statistically significant, correlation between changes in corneal fluorescein staining and symptoms of DED (R = 0.31; P < .001). However, there was no correlation between the recorded change in tear osmolarity and symptoms (R = -0.091; P = .38) or between changes in tear osmolarity and corneal fluorescein staining (R = -0.02; P = .80). This lack of correlation was consistent in all the subgroups studied. A multivariate analysis revealed that changes in corneal fluorescein staining had predictive value on symptom changes, whereas tear osmolarity changes did not. Changes in tear osmolarity do not correlate significantly with changes in patient symptoms or corneal fluorescein staining in dry eye disease.
Highlights
Dry eye disease (DED) is one of the most prevalent causes for ophthalmic consultation in the developed world
Changes in tear osmolarity do not correlate significantly with changes in patient symptoms or corneal fluorescein staining in dry eye disease
We evaluated the correlation between changes in tear osmolarity and changes in signs and symptoms of DED
Summary
Dry eye disease (DED) is one of the most prevalent causes for ophthalmic consultation in the developed world. It is reported that 5 to 35 percent of the general population suffers from moderate to severe DED, and the prevalence increases with age.[1] DED presents in patients of all ages and both sexes, it is more prevalent among older women.[1] Diagnosis and follow-up of DED are complex and are based on a combination of patient-reported symptoms and a series of clinical tests Most of these tests have shown a lack of consistency in assessing the disease, and are always subject to clinical interpretation.[2] none of the available tests used to date for the diagnosis and follow-up of DED have demonstrated very high reliability
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