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Francisco Amparo, Reza Dana; Is the Ocular Surface Disease Index (OSDI©) the Right Tool to Measure Patient Perception of Ocular Surface Symptoms?. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2654.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the correspondence between the symptom scores obtained with two dry eye questionnaires: the Ocular Surface Disease Index (OSDI) and the Symptom Assessment in Dry Eye (SANDE).
Prospective, observational study of a consecutive cohort of patients with dry eye disease (DED) and ocular graft-vs-host disease (GVHD), participants responded both the OSDI, a 12-item symptom questionnaire, and the Symptom Assessment in Dry Eye (SANDE), a 2-item visual analog scale. For each clinical condition we divided the cohort into three subgroups: i) patients with an OSDI score <30, ii) 30-60, and iii) >60. Similarly, we divided the cohort into subgroups defined by a SANDE score i) <30 (mild symptoms), ii) 30-60 (moderate), and iii) >60 (severe), and compared the mean scores obtained with each questionnaire in each subgroup depending if OSDI or SANDE scores were used as the defining criteria.
We obtained 200 evaluations in the dry eye group and 330 in the ocular GVHD group. In the DED group, when patients were categorized by their OSDI scores, the mean scores for each subgroup were: <30: OSDI 17, SANDE 42; 30-60: OSDI 44, SANDE 60, and >60: OSDI 73, SANDE 77. And when defined by their SANDE scores: <30 (mild): OSDI 19, SANDE 21; 30-60 (moderate): OSDI 30, SANDE 47; and >60 (severe): OSDI 46, SANDE 74.In the ocular GVHD group when patients were categorized by OSDI scores: <30: OSDI 17, SANDE 34; 30-60: OSDI 42, SANDE 54; and >60: OSDI 72, SANDE 79. And when defined by SANDE scores: <30 (mild): OSDI 19, SANDE 17; 30-60 (moderate): OSDI 29, SANDE 46; and >60 (severe): OSDI 53, SANDE 76.
When patients are categorized by the severity of their OSDI or SANDE scores, there are major clinical differences between the results of both questionnaires, and this was maintained for both DED and ocular GVHD. These results suggest that OSDI results do not follow a linear magnitude when assessing discomfort as commonly understood by most patients and clinicians, and unlike a visual analog scale (such as SANDE) tends to underestimate patient symptoms of discomfort.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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