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Norihiko Yokoi, Miki Uchino, Yuichi Uchino, MURAT DOGRU, Motoko Kawashima, Aoi Komuro, Yukiko Sonomura, Hiroaki Kato, Kazuo Tsubota, Shigeru Kinoshita; Evaluation of the Validity of the Diagnostic Criteria for Dry Eye in Japan Using Subjective Symptoms: Osaka Study. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4337.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the validity of the diagnostic criteria for dry eye using subjective symptom scores.
This study involved 672 Japanese young and middle-aged office workers who use visual display terminals (VDT). The subjects completed questionnaires sent to them by e-mail designed to detect dry eye diagnosis and risk factors. Dry eye tests, including the Schirmer test, tear film breakup time (BUT), and fluorescein and lissamine green staining were then performed. In the questionnaire, the subjects answered the following questions in regard to subjective symptoms (each given a maximum of 4 points depending on severity): sensitivity of light, dryness, discomfort, redness, heavy eyelids, itchiness, blurred vision, tearing, foreign body sensation, discharge, pain, and eye fatigue. The Japanese dry eye diagnostic criteria, revised in 2006, was followed in this study.
Of the 672 subjects, 561 (374 males, 187 females) completed the questionnaire (response rate: 83.5%). Sixty-five subjects (11.6%) were diagnosed as definite dry eye disease (DED), 303 subjects (54.0%) were diagnosed as suspected DED, and 193 subjects (34.4%) were diagnosed as non-DED. The mean subjective symptom scores of participants with suspected DED (2.05±0.42) and non-DED (1.63±0.38) were significantly less than definite DED (2.19±0.40) (p<0.05). In participants with suspected DED, a subgroup with subjective symptoms and abnormal tear film BUT (<=5 sec.) had a high score (2.09±0.40) equivalent to that of those with definite DED (p=0.269).
The validity of the criteria was confirmed in terms of subjective symptoms. However, suspected DED with abnormal tear film BUT and positive subjective symptoms showed equivalent severity of subjective symptoms of definite DED, and from this result, the importance of examining tear film BUT and the necessity of treatment for this group was indicated.
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