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Santiago Ortiz-Perez, Alfonso Anton-Lopez, Christophe Baudouin; A new tool for fast assessment of ocular surface disease in glaucoma patients. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3743.
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© ARVO (1962-2015); The Authors (2016-present)
The prevalence of OSD (Ocular Surface Disease) is higher in glaucoma patients. The assessment of OSD should be systematically performed as Quality Of Life could be affected, influencing compliance and ultimately progression in visual loss. However, OSD in glaucoma patients tends to be under-diagnosed and under-managed due to time constraints. This study reports the implementation of a new, rapid assessment method, the FAST questionnaire, for OSD evaluation in routine practice.
FAST includes 14 short questions on risk factors, symptoms and signs of OSD, highlighting abnormal results. The questionnaire is divided in two parts: data from the patient interview (demography, risk factors and symptoms) and from the clinical examination. This study is part of an international project involving 7 countries: the objective is to examine correlations between risk factors, symptoms and signs to produce a shorter, validated questionnaire to aid diagnosis of OSD in glaucoma patients.
A total of 301 glaucoma patients recruited from 14 sites in Spain (mean time since diagnosis 9.2±8.3yrs) completed the FAST survey between January and June 2016. 75% of participants were using glaucoma treatments containing preservatives. At least one risk factor was observed in 64% of patients, and 65.4% presented with ≥1 symptom; almost half (46%) reported dry eye symptoms between eye drop instillation and itching/irritation (49%). At least one ocular sign of OSD was recorded in 73.2% of patients. There was a significant association between both ocular signs /symptoms and the time since initial diagnosis (all p<0.001), and between symptoms and number of preserved drops used per day (p<0.05). Ocular redness and corneal staining were significantly linked to the number of preserved glaucoma drops used per day (all p<0.001). The number of preserved glaucoma drops in use was significantly associated with corneal staining: odds ratios 1.82 [1.07-3.09].
These first results from Spain offer interesting insight into the prevalence of OSD in glaucoma patients and also highlight the ease of use of this tool in clinical practice. Almost half of all patients reported symptoms, and OSD was diagnosed in three quarters. The FAST questionnaire appears to be a simple and effective method to help ophthalmologists to evaluate OSD in glaucoma patients which can be completed easily in daily clinical practice.
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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