June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017

Different techniques to statistically analyze the relationship between different ocular staining scores and their correlation with dry eye in Sjögren’s syndrome
Author Affiliations & Notes
  • Karim Mohamed-Noriega
    Oftalmologia, Hospital Universitario, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
  • Fernando Morales-Wong
    Oftalmologia, Hospital Universitario, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
  • Jibran Mohamed-Noriega
    Oftalmologia, Hospital Universitario, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
  • Gerardo Villarreal Méndez
    Oftalmologia, Hospital Universitario, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
  • Janett Riega-Torres
    Reumatología, Hospital Universitario, Universidad Autónoma de Nuevo Leon,, Monterrey, Nuevo Leon, Mexico
  • Mario Alberto Garza-Elizondo
    Reumatología, Hospital Universitario, Universidad Autónoma de Nuevo Leon,, Monterrey, Nuevo Leon, Mexico
  • Jesus Mohamed
    Oftalmologia, Hospital Universitario, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
  • Footnotes
    Commercial Relationships   Karim Mohamed-Noriega, None; Fernando Morales-Wong, None; Jibran Mohamed-Noriega, None; Gerardo Villarreal Méndez, None; Janett Riega-Torres, None; Mario Garza-Elizondo, None; Jesus Mohamed, None
  • Footnotes
    Support  PAICYT 2015 SA161-15
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2697. doi:
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      Karim Mohamed-Noriega, Fernando Morales-Wong, Jibran Mohamed-Noriega, Gerardo Villarreal Méndez, Janett Riega-Torres, Mario Alberto Garza-Elizondo, Jesus Mohamed;
      Different techniques to statistically analyze the relationship between different ocular staining scores and their correlation with dry eye in Sjögren’s syndrome. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2697.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To correlate 3 different Ocular Surface Staining (OSS) scores: Oxford, NEI-CLEK and SICCA OSS and analyze the relationship between them and with Schirmer's test, tear break-up time (TBUT) and tear osmolarity (Osm) in patients with primary and secondary Sjögren’s syndrome (SS).

Methods : This is a prospective, consecutive, transversal case series of patients with SS confirmed with salivary gland biopsy, serology and/or SICCA OSS according to 2012 classification criteria for SS. The dry eye evaluations included TBUT, Schirmer’s test without anesthesia, Osm, and the 3 different OSS scores (Oxford, NEI-CLEK and SICCA OSS). The analysis was performed with Spearman's correlation test, Kappa agreement test and Bland-Altman diagrams.

Results : We evaluated 189 eyes of 95 patients: Mean age ± standard deviation (SD) was 53.38 ± 12.24 years. The OSS scores showed a significant very strong positive correlation and a fair agreement between them: Oxford vs NEI-CLEK: rho: 0.819, p<0.001, kappa:0.496. Oxford vs SICA OSS: rho: 0.862, p<0.001, kappa: 0.507. NEI CLEK vs SICCA OSS: rho: 0.847, p<0.001, kappa: 0.366. Bland-Altman scatterplots showed: Oxford vs NEI-CLEK: difference between tests was not related to the severity of the disease, but a mild tendency to increase differences in more severe cases. Oxford vs SICA OSS: a discrete increase in differences between tests with increasing severity of the staining. NEI CLEK vs SICCA OSS: a discrete tendency to increase differences between tests in moderated cases and reduced differences in mild and severe cases.
All OSS correlated significantly with most variables, Schirmer's test showed moderate correlation with SICCA OSS and Oxford. Osm showed moderate correlation with SICCA OSS and weak correlation with another OSS.

Conclusions : The Spearman’s correlation test showed very strong significant positive correlation between all OSS scores. The Kappa analysis showed a fair agreement between all OSS scores. The Bland-Altman diagrams showed a valid limit of agreement between all OSS, the differences between tests were mostly random with a mild tendency to increase differences in more severe cases. The three staining scores are adequate to evaluate the ocular surface and its severity; we suggest further analysis of sensitivity and specificity

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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