Falta de concordancia entre los cuestionarios y las pruebas diagnósticas en el síndrome de ojo seco

  1. G. Fuentes-Páez
  2. J.M. Herreras
  3. Y. Cordero
  4. A. Almaraz
  5. M.J. González
  6. M. Calonge
Revista:
Archivos de la Sociedad Española de Oftalmologia

ISSN: 0365-6691

Ano de publicación: 2011

Volume: 86

Número: 1

Páxinas: 3-7

Tipo: Artigo

DOI: 10.1016/J.OFTAL.2010.07.004 DIALNET GOOGLE SCHOLAR lock_openAcceso aberto editor

Outras publicacións en: Archivos de la Sociedad Española de Oftalmologia

Obxectivos de Desenvolvemento Sustentable

Resumo

Purpose: To report the prevalence of dry eye syndrome (DES) in a subset of patients > 50 years old in Valladolid, Spain, calculate internal validity of two DES screening questionnaires, and correlate the results with DES diagnostic tests. Methods: Patients > 50 years-old were randomly selected from the medical network census in Valladolid; they answered the modified McMonnies questionnaire (Q1) and the Ocular Surface Index questionnaire (Q2) and then underwent an ophthalmic evaluation which included: tear break-up time (TBUT), fluorescein and Rose Bengal staining, and Schirmer with anesthesia were performed. Descriptive analysis, test concordance analysis, and Q1 and Q2 reliability using ROC curves were performed. Results: A total of 270 subjects (58.2% female; 41.8% male) with an average age of 64.5 years (95% CI: 63.3 - 65.7) were enrolled. The prevalence of DES based on the Schirmer-Tear break-up time tests combination was 24.2%. The mean Q1 score was 1.2, and 1.4 for Q2. Grittiness and discomfort in dry environments (28.9%) were the most common symptoms recorded for Q1. For Q2 "grittiness" (99.2%) and "burning sensation" (98.9%) were the most common symptoms. With the Schirmer-TBUT combination, DES prevalence in Valladolid was 24.2%, 45.8% with TBUT, and 45.6% with Schirmer test. Values for the areas under the ROC curve for Q1, Q2, and most objective tests were < 0.5, except for Q2 and TBUT (0.503). Cronbach alpha was > 0.7 for all Q1 and Q2 items. Statistically significant concordance was reported for Schirmer - TBUT (κ=0.14) and TBUT- fluorescein staining (κ=0.09); (P<0.05). Conclusions: Q1 and Q2 were unreliable for DES diagnosis and showed poor internal consistency. Fluorescein and Rose Bengal staining were the most concordant tests for DES diagnosis. Finally, there was no correlation between either screening questionnaire and objective DES diagnostic tests.

Referencias bibliográficas

  • Stern, ME, Gao, J, Siemasko, KF. (2004). The role of the lacrimal functional unit in thepathophysiology of dry eye. Exp Eye Res.. 78. 409
  • Nichols, KK, Nichols, JJ, Mitchell, GL. (2004). The reliability and validity of McMonnies Dry Eye Index. Cornea. 23. 365
  • McMonnies, CW, Ho, A. (1987). Patient history in screening for dry eye conditions. J Am Optom Assoc.. 58. 296-301
  • Schiffman, RM, Christianson, MD, Jacobsen, G, Hirsch, JD, Reis, BL. (2000). Reliability and validity of the Ocular Surface Disease Index. Arch Ophthalmol.. 118. 615
  • Herreras, JM, Pérez, S, Pérez, S, Calonge, M, Pastor, JC. (1997). Influence of topical anesthesia on tests diagnostic of blepharitis-associated dry eye syndrome. Ocul Immunol Inflamm.. 5. 33-41
  • Bjerrum, KB. (1996). Tests and symptoms in keratoconjunctivitis sicca and their correlation. Acta Ophthalmol Scand.. 74. 436
  • Farris, RL, Gilbard, JP, Stuchell, RN, Mandel, ID. (1983). Diagnostic tests in keratoconjunctivitis sicca. CLAO J.. 9. 23
  • Lucca, JA, Nunez, JN, Farris, RL. (1990). A comparison of diagnostic tests for keratoconjunctivitis sicca: lactoplate, Schirmer, and tear osmolarity. CLAO J.. 16. 109
  • Versura, P, Frigato, M, Cellini, M, Mulè, R, Malavolta, N, Campos, EC. (2007). Diagnostic performance of tear function tests in Sjogrens syndrome patients. Eye (Lond). 229
  • Donate, J, Benítez del Castillo, JM, Fernández, C, García Sánchez, J. (2002). Validation of a questionnaire for the diagnosis of dry eye. Arch Soc Esp Oftalmol.. 77. 493-500
  • Goren, MB, Goren, SB. (1988). Diagnostic tests in patients with symptoms of keratoconjunctivitis sicca. Am J Ophthalmol.. 106. 570
  • Nichols, KK, Mitchell, GL, Zadnik, K. (2004). The repeatability of clinical measurements of dry eye. Cornea. 23. 272
  • Nichols, KK, Nichols, JJ, Mitchell, GL. (2004). The lack of association between signs and symptoms in patients with dry eye disease. Cornea. 23. 762
  • Yu, CH. An introduction to computing and interpreting Cronbach coefficient alpha in SAS.
  • Harper, R, Reeves, B. (1999). Compliance with methodological standards when evaluating ophthalmic diagnostic tests. Invest Ophthal Vis Sci.. 40. 1650
Fonte de datos: Dialnet