July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Clinical Signs in Dry Eye: a multicentric cross-sectional study
Author Affiliations & Notes
  • Elisa Cantalamessa
    University of Milan. San Giuseppe Hospital, Milan, Italy
  • Edoardo Villani
    University of Milan. San Giuseppe Hospital, Milan, Italy
  • Paolo Nucci
    University of Milan. San Giuseppe Hospital, Milan, Italy
  • Maurizio Rolando
    IS.PRE Oftalmica, Genoa, Italy
  • Footnotes
    Commercial Relationships   Elisa Cantalamessa, None; Edoardo Villani, Allergan (C), Bausch & Lomb (R), FB Vision (C), Shire (R), Sooft (R); Paolo Nucci, None; Maurizio Rolando, Allergan (C), Allergan (F), Bausch & Lomb (C), Novartis (C), Santen (C), Sifi (C), Thea (C)
  • Footnotes
    Support  Allergan Unrestricted Grant
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 4871. doi:
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      Elisa Cantalamessa, Edoardo Villani, Paolo Nucci, Maurizio Rolando; Clinical Signs in Dry Eye: a multicentric cross-sectional study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4871.

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

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Purpose : Several clinical signs of Dry Eye may be evaluated by minimally invasive and most accessible methods. However their clinical utility is limited by lack of knowledge of their diagnostic value and by poor association with symptoms. The aim of this exploratory research was to investigate low-tech clinical signs profiles in patients with Dry Eye.

Methods : We performed a multicentric cross-sectional study, collecting clinical data from patients with Dry Eye who underwent eye examination in 11 Italian second-level Ocular Surface Centers between July 2017 and October 2017. Collected data included systemic co-morbidities and treatments, ocular therapies, ocular surface symptoms’ type and duration and ocular surface signs. We assessed and graded 19 eyelid, 29 conjunctival, 28 corneal, and 12 tear film abnormalities.

Results : We included 707 eyes (rights:lefts, 357:350) of 397 patients (male:female, 105:292; 61±17.38 years old). The most frequent systemic co-morbidities were cardiovascular (45.4%) and rheumatologic (37.1%) diseases; P<0.01, Chi-Square test. 16.5% of our patients were taking 5 systemic drugs or more. 72.4% of patients were using topical therapies (artificial tears in 83.2% of cases). The mean number of drops instilled per day was 4.55±3.39.
Burning and foreign body sensation were the most frequently reported symptoms (54.8% and 47.6%, respectively; P<0.001), while only 11.3% of subjects complained of dryness.
The most frequent eyelid abnormalities were hyperemia (72.3%), bridge vessels across the margin (66.2%), and notching (60.3%); in each case P<0.01. The most frequent conjunctival abnormalities were nasal staining (46.2%), conjunctivochalasis (43%), and hyperemia (40.3%); in each case P<0.01. The most frequent corneal abnormality was inferior staining (38.8%; P<0.001). The most frequent tear film abnormalities were reduced break-up time (71.3%), reduced tear menisci (63.2%), and irregular tear menisci (61%), followed by dirty tear film (50.9%) and reduced tears secretion (48.9%).
Cluster analysis based on clinical signs allowed us to identify homogeneous groups of patients.

Conclusions : Low-tech examination of Dry Eye patients can provide several important information. The clinical utility of the signs-based clusters of patients needs to be further investigated.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.


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