Predictors of discordance help assess patients with dry eye
The discordance between symptoms and signs in dry eye disease (DED) is an indicator of self-perceived health, according to a study, which has found significant predictors of both greater and lesser symptoms to signs.
This cross-sectional study that investigated predictors of discordance between symptoms and signs in DED involved a total of 648 patients (mean age 55.8 years; 82.7 percent female) with dry eye from the Groningen Longitudinal Sicca Study, a tertiary dry eye clinic patient cohort from the Netherlands.
Researchers used the Ocular Surface Disease Index (OSDI) questionnaire to assess patient symptoms. They evaluated dry eye signs by tear osmolarity, Schirmer test, tear breakup time, corneal and conjunctival staining, and meibomian gland dysfunction, all in both eyes; a composite dry eye signs severity score was calculated from these six tests for each patient.
Linear regression analysis was conducted to examine the association of discordance between symptoms and signs with a wide range of independent variables (demographic and environmental variables, systemic diseases, ocular traits, and medications).
The presence of a chronic pain syndrome, atopic diseases, a known allergy, the use of antihistamines (p<0.001 for all), depression (p=0.003), osteoarthritis (p=0.008) and the use of antidepressants (p=0.02) were all significant predictors of greater symptoms than signs.
Predictors of lesser symptoms than signs were increased age (p<0.001) and the presence of Sjögren's disease (p<0.001; primary Sjögren's disease, p<0.001) more than secondary Sjögren's disease (p=0.08), and graft-versus-host disease (p=0.04). Furthermore, greater symptoms were highly associated with lower self-perceived health than signs (p<0.001).
“Awareness of these predictors is helpful in assessing patients with dry eye in clinical practice,” according to researchers.