KMID : 1159320190210030389
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Korean Journal of Vision Science 2019 Volume.21 No. 3 p.389 ~ p.399
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Screening Method for Inflammatory Dry Eye
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Park Min-Hye
Park Jung-Eun Byun Jang-Won Choi Min-Ji Cho Il-Hoon Jeong Myeong-Jin Lee Koon-Ja
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Abstract
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Purpose: To propose an algorithm for screening of inflammatory dry eye using tear tests, corneal staining and conjunctival hyperemia
Methods: A total of 81 patients in 20-30s without ophthalmologic diseases participated. The inflammatory dry eyes were diagnosed using MMP-9 (metalloproteinase-9) test and performed Shirmer test, TBUT (tear break-up time), corneal staining and conjunctival hyperemia. Dry eye refers to the criteria which specifies the OSDI (ocular surface disease index) score of more than 12, TBUT (tear film break-up time) of less 5 seconds, Schirmer test without anesthesia of less than 5mm/5minutes, corneal staining, and conjunctival hyperemia more than grade 1. Chi-square test was used to find out the correlation between tear/ocular surface test and MMP-9 test, and ROC curve was used for the sensitivity, specificity and AUC (area under the curve) for the algorithm of inflammatory dry eye.
Results: Neither of the methods, Schirmer test nor TBUT, showed statistically significant correlation with positive MMP-9 results(p>0.050). And, OSDI, corneal staining, and conjunctival hyperemia were significantly correlated with MMP-9 result(p<0.050). Among the OSDI scores, corneal staining, and conjunctival hyperemia, the sensitivity, specificity, and AUC for screening of inflammatory dry eye were as follows. The sensitivity, specificity, and AUC of ¡®OSDI/corneal staining/conjunctival hyperemia¡¯ were 44.00%, 100.00%, 0.720, and ¡®OSDI/corneal staining¡¯ were 44.00% 94.59%, 0.693, ¡®OSDI/conjunctival hyperemia¡¯ were 76.80%, 75.68%, 0.762, and ¡®corneal staining/conjunctival hyperemia were 52.80% 97.30%, 0.750, respectively, showing that ¡®OSDI/conjunctival hyperemia¡¯ was highest accuracy.
Conclusion: The algorithm of ¡®OSDI/conjunctival hyperemia¡¯ showed high accuracy similar to MMP-9 test. It would be a useful method for screening inflammatory dry eye.
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KEYWORD
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Conjunctival hyperemia, Corneal staining, Dry eye, Inflammatory, MMP-9, OSDI
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