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Assessment tool accurately identifies patients at risk for dry eye
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The Dry Eye Risk Assessment as a standalone instrument accurately identifies patients at risk for dry eye close to its previously established sensitivity at 87% and specificity at 74%, according to researchers at the Association for Research in Vision and Ophthalmology.
The Dry Eye Risk Assessment (DERA) and the Dry Eye Questionnaire (DEQ-5) were administered to patients at 11 clinical sites. Each investigator was masked to initial responses and allowed to choose at minimum one clinical test to qualify the subject as dry or normal using: tear break-up time, Efron corneal or conjunctival staining, meibomian gland expression quality and phenol red thread test.
Subjects were classified according to the Dry Eye Workshop II definitions as normal, dry eye disease, signs without symptoms (predisposition) or symptoms without signs (preclinical).
Eighty-seven subjects were an average age of 50.7 years old.
Researchers found a 72.8% agreement between investigator opinion and DERA. In cases where symptoms per DEQ-5 and at least one sign were used, agreement between that diagnosis and DERA was 76.2%.
Using the DEQ-5 responses patients were graded as: 22 normal subjects, 38 subjects with a score of at least 6 and less than 12, and 27 participants with a score of at least 12.
According to DEWS II there were: 10 normal subjects, 64 subjects with dry eye disease, nine subjects with predisposition and one subject as preclinical.
DERA identified 71 subjects at risk.
"Traditionally, risk factors for dry eye are either consistent, probably or inconclusive,” lead researcher Justin Kwan, OD, FAAO, told Primary Care Optometry News. “Calculators exist for coronary heart disease and glaucoma, for instance. After refining a new set of risk factor questions, the five items that remain were age, seeing a doctor regularly, sinus issues, migraines and use of eye drops.
“DERA is essentially a calculator that is able to predict dry eye by symptoms (DEQ-5) and one clinical sign 76.2% of the time,” Kwan continued. “This has applications in primary care and screening settings or in an eye care provider's clinic as well.”
The researchers wrote that DERA, “the simple yet powerful” dry eye risk calculator, can help assess which patients might require testing and treatment to ensure appropriate eye performance and comfort throughout the day. – by Abigail Sutton
Reference:
Kwan J, et al. Dry Eye Risk Assessment (DERA): Predictive value of newly identified risk factors. Presented at: Association for Research in Vision and Ophthalmology; Honolulu; April 29-May 3, 2018.
Disclosures: Kwan receives financial support or consulting fees from Johnson & Johnson Vision and Visioneering Technologies Inc. Please see the full study for all remaining authors’ financial disclosures.