Abstract
Abstract: :
Purpose: To determine which questions best discriminate between patients with Sjögren's Syndrome (SS) and keratoconjunctivitis sicca (KCS) in a multi-centered pilot study. Methods: 15 SS and 30 KCS patients completed the Dry Eye Questionnaire (DEQ), the McMonnies' Questionnaire (MQ), and the Schein Questionnaire (SQ). Odds ratios (OR) for symptoms that appeared on more than one instrument were compared. Results: SS patients reported more frequent and intense symptoms than KCS patients. Morning (AM) symptoms better differentiated between the two groups than evening (PM) symptoms. Using a criterion of moderate to intense symptoms: 80% of SS and 43% of KCS patients reported AM dryness (OR=1.9), while 100% of SS and 73% of KCS reported PM dryness (OR=1.4); 67% of SS and 34% of KCS reported AM soreness (OR=2.0) while 93% of SS and 57% of KCS reported PM soreness (OR=1.6); 67% of SS and 27% of KCS reported AM grittiness (OR=2.5) and 93% of SS and 53% of KCS reported PM grittiness (OR=1.8), and 73% of SS and 40% of KCS reported AM discomfort (OR=1.8) while 93% of SS and 70% of KCS reported PM discomfort (OR=1.3). Due to the high number of KCS reporting frequent to constant symptoms, questions on frequency of symptoms did not discriminate as well as intensity questions (OR range 1.2-1.5). On the MQ, 100% of SS and 76% of KCS reported dryness (OR 1.3), 93% of SS and 73% of KCS reported burning (OR=1.3), and 93% of SS and 53% of KCS patients reported soreness (OR 1.8). Discomfort on waking was reported by 73% of SS and 40% of KCS patients (OR 1.8). On the SQ, 100% of SS and 65% of KCS patients reported dryness (OR=1.5). Conclusion: AM intensity questions on the DEQ (dryness, soreness, grittiness and discomfort) showed the greatest ability to discriminate between patients with SS and KCS. An understanding of differences in the diurnal reporting pattern of symptoms between these groups may lead to novel treatment strategies. This project was funded by Alcon Research Limited. Acknowledgements: Drs. B Caffery, T Edrington, JD Nelson, T Simpson & C Snyder.
Keywords: 376 cornea: tears/tear film/dry eye • 355 clinical (human) or epidemiologic studies: risk factor assessment