Half of the people were diagnosed with dry eye, but there was no difference in OSDI scores (that's the popular symptom questionnaire) between those with and without clinically proven dry eye. OSDI didn't correlate with any of the 'objective' test findings enough to write home about. Huh??
So... we conclude that dry eye is (a) not a bit deal and (b) confusing in dry eye patients? I'd be more tempted to conclude that we ditch OSDI for a better questionnaire, and/or broaden the clinical testing we compare it with. Just doesn't make sense to me.
Evaluation of dry eye signs and symptoms in patients with systemic sclerosis.
One of the most frequent ocular features of systemic sclerosis (SSc) is dry eye disease (DED), which has been identified to occur in 37-79% of patients. Although several studies have found weak or no correlations between symptoms and signs of dry eye, symptoms are often the motivation for seeking eye care, and are therefore a critical outcome measure when assessing treatment effect. The aim of this study is to evaluate the impact of symptoms of dry eye on vision-related quality of life in patients with systemic sclerosis, and to investigate the relation between clinical tests and symptoms of dry eye in these patients.
In this cross-sectional study, 45 consecutive patients with SSc were enrolled. For evaluation of the symptoms the "Ocular Surface Disease Index (OSDI)" questionnaire was applied to all patients. After that, all individuals were submitted to a full ophthalmic examination, including the following tests: tear break-up time, Schirmer I, rose bengal staining. Patients were then grouped into dry eye and non-dry eye groups with regard to the diagnosis of dry eye. Mann-Whitney test was used to compare continuous variables, whereas the Fisher exact test was used to compare categorical data between groups. Spearman's correlation test was used to analyze the correlations between clinical tests and OSDI scores. P values <0.05 were considered significant.
Dry eye disease was diagnosed in 22 patients (48.9%). Other ocular surface abnormalities found were: blepharitis (40% of the patients), pterygium (15.6%), pinguecula (82.2%), and superficial punctate keratitis (26.7%). Among the 45 patients, 29 patients (64.4%) had symptoms of ocular surface disease. The mean OSDI score was 26.8 ± 25.8 (SD). There were no statistically significant differences in OSDI scores between DED and non-DED patients. No substantive correlations were found between OSDI scores and TBUT, Schirmer I, or rose bengal staining score, and none of the observed correlations reached statistical significance.
Symptoms of dry eye have a moderate impact on vision-related quality of life in patients with systemic sclerosis and do not correlate well with clinical findings.
Graefes Arch Clin Exp Ophthalmol. 2012 Feb 18. [Epub ahead of print]
de A F Gomes B, Santhiago MR, de Azevedo MN, Moraes HV Jr.
Department of Ophthalmology, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.