Evaluation of the Ocular Surface Disease Index Questionnaire as a Discriminative Test for Clinical Findings in Dry Eye Disease Patients

• Published in: Current eye research Vol. 44; no. 9; pp. 941 - 947
• Main Authors: Yazdani, Mazyar, Chen, Xiangjun, Tashbayev, Behzod, Utheim, Øygunn A., Ræder, Sten, Hua, Yanjun, Eidet, Jon R., Stojanovic, Aleksandar, Dartt, Darlene A., Utheim, Tor P.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 02.09.2019
• Subjects: clinical tests; Dry eye disease; ocular surface disease index (OSDI); receiver-operating characteristic (ROC) curve analysis; clinical tests; receiver-operating characteristic (ROC) curve analysis; ocular surface disease index (OSDI); Dry eye disease
• ISSN: 0271-3683; 1460-2202
• DOI: 10.1080/02713683.2019.1604972

To investigate to what extent the OSDI can be utilized as a discriminative test for clinical findings. One thousand and ninety patients with dry eye disease (DED) were consecutively included and examined for osmolarity, tear film break-up time (TFBUT), ocular protection index (OPI), ocular surface staining (OSS), Schirmer I test (ST), meibum expressibility (ME), meibum quality (MQ), and diagnosis of meibomian gland dysfunction (MGD). Receiver-operating characteristic curve (ROC) analysis considering optimum balanced sensitivity and specificity (close to 50%) was used for assessment. The present study on more than 1,000 patients indicates that the OSDI in the ROC curve analysis is a poor discriminator of pathological scores for TFBUT ≤ 5 (AUC = 0.553; p = .012) and ≤10 s (AUC = 0.608; p = .002), OSS ≥ 3 (AUC = 0.54; p = .043), ST ≤ 5 (AUC = 0.550; p = .032) and ≤10 mm/5 min (AUC = 0.544; p = .016), and ME ≥ 1 (AUC = 0.594; p = <0.001). Pathological scores for osmolarity >308 and >316 mOsm/L, OPI, OSS > 1, MQ, and MGD could not be discriminated by OSDI (p > .05). Cut-off values for the OSDI can be defined to discriminate pathological TFBUT (≤5 and ≤10), OSS (≥3), ST (≤5 and ≤10) and ME, however, the discriminability was low. Our comprehensive study emphasises the importance of taking both symptoms and signs into account in DED management.