Abstract
Purpose: :
The purpose of this study was to follow patients with kerotoconjunctivitis sicca (KCS) over time and evaluate their clinical and patient reported outcomes in the routine clinical practise.
Methods: :
This was a prospective, single–centre, registry of adults with moderate to severe KCS recruited between March 2002 and June 2005. Clinical outcomes included corneal and conjunctival staining (Oxford Grading), Tear Break–Up Time (TBUT), Tear Function Index (TFI) and the physician’s assessment of severity. The patient reported outcomes included the Ocular Surface Disease Index (OSDI) and the Dry Eye Disease Impact Questionnaire (DEDIQ).
Results: :
Data from 75 patients were analysed, of which 91% were female. Sjogren’s syndrome comprised 73% of all diagnoses. Fifty nine percent of patients had four follow–up visits (mean 15.8 months). At baseline, 46% assessed their dry eye as moderate and 43% rated it as severe. Physicians rated more patients as moderate (61%) than severe (36%). Of the patients rated as severe at baseline by the physician and seen at visit 4 (n=16), 75% improved to moderate and 25% improved to mild by visit 4. By the patient’s assessment (n=18), 39% of the patients remained severe, 44% improved to moderate and 17% improved to mild by visit 4. Preliminary analysis of the use of dry eye medications by patients who indicated an improvement in their dry eye severity showed an increase in use of dry eye medications. The DEDIQ showed dry eye disease impact on daily activities and quality of life (QoL) increased with increasing disease severity. Correlations between disease impact and disease severity at visit 4 were significant relative to leisure activities, life enjoyment, normal work, and mood.
Conclusions: :
Dry eye disease has a significant impact on patient’s activities and QoL, which increased with disease severity. An improvement in severity was observed in the majority of patients with severe dry eye and was associated with an increased use of dry eye medications. This registry offers a unique opportunity to follow KCS in routine clinical practise.
Keywords: cornea: tears/tear film/dry eye • clinical (human) or epidemiologic studies: outcomes/complications • clinical (human) or epidemiologic studies: health care delivery/economics/manpower