June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Comparing Schirmer’s test with other clinical outcomes in dry eye
Author Affiliations & Notes
  • Jeffrey Gemi
    Ora, Inc., Andover, Massachusetts, United States
  • Michael Watson
    Ora, Inc., Andover, Massachusetts, United States
  • Divya Narayanan
    Ora, Inc., Andover, Massachusetts, United States
  • George W Ousler
    Ora, Inc., Andover, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Jeffrey Gemi, Ora (E); Michael Watson, Ora (E); Divya Narayanan, Ora (E); George Ousler, Ora (E)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1271. doi:
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    • Get Citation

      Jeffrey Gemi, Michael Watson, Divya Narayanan, George W Ousler; Comparing Schirmer’s test with other clinical outcomes in dry eye. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1271.

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

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Abstract

Purpose : Dry eye disease (DED) can be a debilitating disease of the eye. With several clinical tools available to evaluate severity and impact of the disease, it is often unclear how outcomes assessed using one test relates to others, specifically outside the context of therapeutic interventions. In this study, several different clinical tests were compared to examine their relationships.

Methods : Subjects (N=1149), who were brought in for screening prior to any therapeutic intervention were included for this analysis. The mean age (±SD) was 57.4±15.5 years; 70% of the subjects were females and 30% were males. Subjects were divided into three groups based on results from unanesthetized Schirmer’s Test; Normal group: Schirmer’s >10mm, Borderline: Schirmer’s = 6 to 10mm, Severe DED: Schirmer’s ≤ 5mm. Several outcomes including corneal fluorescein staining (CFS) total and regional (NEI grading), Ocular Surface Disease Index (OSDI) overall score, disease duration and age were compared between the groups. For CFS, each region was graded on a scale of 0 to 3, with a total possible maximum score of 15. Correlation coefficient (R) was calculated for continuous variables. ANOVA was used for group comparisons. Only data from the right eye was included for analysis.

Results : Schirmer’s scores showed significant moderate correlation with total CFS (R=-0.29, p<0.0001). CFS was progressively worse in groups with reduced Schirmer’s score. Total CFS was 9.2±2.4 in severe Schirmer’s group and 8.9±2.4 in the borderline group compared to 7.4±2.7 in normal group (p<0.0001 for both comparisons vs normal). These results were also consistent for all 5 sub-regional staining analysis. Inferior CFS was 2.1±0.6 in severe group, 2.0±0.6 in borderline group and 1.8±0.7 in the normal group (p<0.0001 for both comparisons vs normal). Schirmer’s score showed significant mild correlation with age (R=-0.11, p=0.0001) with severe subjects being significantly older (mean 61.1±13.4 years) than those with normal Schirmer’s (mean 54.7±16.6 years) (p<0.0001). Severe subjects also had significantly longer DED duration (mean 11.5±9.2 years) than those with normal Schirmer’s (mean 9.8±8.8 years) (p=0.02).

Conclusions : Schirmer’s score captures DED intensity that aligns with total and regional corneal staining measures as well as age and duration.

This is a 2021 ARVO Annual Meeting abstract.

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