Dry-eye screening by using a functional visual acuity measurement system: The Osaka study

Minako Kaido, Miki Uchino, Norihiko Yokoi, Yuichi Uchino, Murat Dogru, Motoko Kawashima, Aoi Komuro, Yukiko Sonomura, Hiroaki Kato, Shigeru Kinoshita, Kazuo Tsubota

研究成果: Article

23 引用 (Scopus)

抄録

Purpose. We determined whether functional visual acuity (VA) parameters and a dry eyes (DEs) symptoms questionnaire could predict DEs in a population of visual terminal display (VDT) users. Methods. This prospective study included 491 VDT users from the Osaka Study. Subjects with definite DE, diagnosed with the presence of DE symptoms, tear abnormality (Schirmer test ≤ 5 mm or tear breakup time [TBUT] ≤ 5 seconds), and conjunctivocorneal epithelial damage (total staining score of ≥3 points), or probable DE, diagnosed with the presence of two of them, were assigned to a DE group, and the remainder to a non-DE group. Functional VA was assessed, and DE questionnaires were administered. We assessed whether univariate and discriminant analyses could determine to which group a subject belonged. Sensitivity and specificity were assessed. Results. Of 491 subjects, 320 and 171 were assigned to the DE and non-DE groups, respectively. No significant differences were observed between DE and non-DE groups in Schirmer test value and epithelial damage, but TBUT value (3.1 ± 1.5 vs. 5.9 ± 3.0 seconds). The sensitivity and specificity of single test using functional VA parameters were 59% and 49% in functional VA, 60% and 50% in visual maintenance ratio, and 83% and 30% in frequency of blinking, respectively. According to a discriminant analysis using a combination of functional VA parameters and a DE questionnaire, six variables were selected for the discriminant equation, of which area under the curve (AUC) was 0.735. Sensitivity and specificity of diagnoses predicted by the discriminant equation were 85.9% and 45.6%, respectively. Conclusions. The discriminant equation obtained using functional VA measurement combined with a symptoms questionnaire may suggest the possibility for the first step screening of DE with unstable tear film. Since the questionnaire has an overall poor sensitivity and specificity, further amelioration may be necessary for the actual utilization of this screening tool.

元の言語English
ページ(範囲)3275-3281
ページ数7
ジャーナルInvestigative Ophthalmology and Visual Science
55
発行部数5
DOI
出版物ステータスPublished - 2014 5 6

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Visual Acuity
Tears
Sensitivity and Specificity
Discriminant Analysis
Blinking
Area Under Curve
Maintenance
Surveys and Questionnaires
Prospective Studies
Staining and Labeling

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

これを引用

Dry-eye screening by using a functional visual acuity measurement system : The Osaka study. / Kaido, Minako; Uchino, Miki; Yokoi, Norihiko; Uchino, Yuichi; Dogru, Murat; Kawashima, Motoko; Komuro, Aoi; Sonomura, Yukiko; Kato, Hiroaki; Kinoshita, Shigeru; Tsubota, Kazuo.

:: Investigative Ophthalmology and Visual Science, 巻 55, 番号 5, 06.05.2014, p. 3275-3281.

研究成果: Article

Kaido, M, Uchino, M, Yokoi, N, Uchino, Y, Dogru, M, Kawashima, M, Komuro, A, Sonomura, Y, Kato, H, Kinoshita, S & Tsubota, K 2014, 'Dry-eye screening by using a functional visual acuity measurement system: The Osaka study', Investigative Ophthalmology and Visual Science, 巻. 55, 番号 5, pp. 3275-3281. https://doi.org/10.1167/iovs.13-13000
Kaido, Minako ; Uchino, Miki ; Yokoi, Norihiko ; Uchino, Yuichi ; Dogru, Murat ; Kawashima, Motoko ; Komuro, Aoi ; Sonomura, Yukiko ; Kato, Hiroaki ; Kinoshita, Shigeru ; Tsubota, Kazuo. / Dry-eye screening by using a functional visual acuity measurement system : The Osaka study. :: Investigative Ophthalmology and Visual Science. 2014 ; 巻 55, 番号 5. pp. 3275-3281.
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abstract = "Purpose. We determined whether functional visual acuity (VA) parameters and a dry eyes (DEs) symptoms questionnaire could predict DEs in a population of visual terminal display (VDT) users. Methods. This prospective study included 491 VDT users from the Osaka Study. Subjects with definite DE, diagnosed with the presence of DE symptoms, tear abnormality (Schirmer test ≤ 5 mm or tear breakup time [TBUT] ≤ 5 seconds), and conjunctivocorneal epithelial damage (total staining score of ≥3 points), or probable DE, diagnosed with the presence of two of them, were assigned to a DE group, and the remainder to a non-DE group. Functional VA was assessed, and DE questionnaires were administered. We assessed whether univariate and discriminant analyses could determine to which group a subject belonged. Sensitivity and specificity were assessed. Results. Of 491 subjects, 320 and 171 were assigned to the DE and non-DE groups, respectively. No significant differences were observed between DE and non-DE groups in Schirmer test value and epithelial damage, but TBUT value (3.1 ± 1.5 vs. 5.9 ± 3.0 seconds). The sensitivity and specificity of single test using functional VA parameters were 59{\%} and 49{\%} in functional VA, 60{\%} and 50{\%} in visual maintenance ratio, and 83{\%} and 30{\%} in frequency of blinking, respectively. According to a discriminant analysis using a combination of functional VA parameters and a DE questionnaire, six variables were selected for the discriminant equation, of which area under the curve (AUC) was 0.735. Sensitivity and specificity of diagnoses predicted by the discriminant equation were 85.9{\%} and 45.6{\%}, respectively. Conclusions. The discriminant equation obtained using functional VA measurement combined with a symptoms questionnaire may suggest the possibility for the first step screening of DE with unstable tear film. Since the questionnaire has an overall poor sensitivity and specificity, further amelioration may be necessary for the actual utilization of this screening tool.",
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T1 - Dry-eye screening by using a functional visual acuity measurement system

T2 - The Osaka study

AU - Kaido, Minako

AU - Uchino, Miki

AU - Yokoi, Norihiko

AU - Uchino, Yuichi

AU - Dogru, Murat

AU - Kawashima, Motoko

AU - Komuro, Aoi

AU - Sonomura, Yukiko

AU - Kato, Hiroaki

AU - Kinoshita, Shigeru

AU - Tsubota, Kazuo

PY - 2014/5/6

Y1 - 2014/5/6

N2 - Purpose. We determined whether functional visual acuity (VA) parameters and a dry eyes (DEs) symptoms questionnaire could predict DEs in a population of visual terminal display (VDT) users. Methods. This prospective study included 491 VDT users from the Osaka Study. Subjects with definite DE, diagnosed with the presence of DE symptoms, tear abnormality (Schirmer test ≤ 5 mm or tear breakup time [TBUT] ≤ 5 seconds), and conjunctivocorneal epithelial damage (total staining score of ≥3 points), or probable DE, diagnosed with the presence of two of them, were assigned to a DE group, and the remainder to a non-DE group. Functional VA was assessed, and DE questionnaires were administered. We assessed whether univariate and discriminant analyses could determine to which group a subject belonged. Sensitivity and specificity were assessed. Results. Of 491 subjects, 320 and 171 were assigned to the DE and non-DE groups, respectively. No significant differences were observed between DE and non-DE groups in Schirmer test value and epithelial damage, but TBUT value (3.1 ± 1.5 vs. 5.9 ± 3.0 seconds). The sensitivity and specificity of single test using functional VA parameters were 59% and 49% in functional VA, 60% and 50% in visual maintenance ratio, and 83% and 30% in frequency of blinking, respectively. According to a discriminant analysis using a combination of functional VA parameters and a DE questionnaire, six variables were selected for the discriminant equation, of which area under the curve (AUC) was 0.735. Sensitivity and specificity of diagnoses predicted by the discriminant equation were 85.9% and 45.6%, respectively. Conclusions. The discriminant equation obtained using functional VA measurement combined with a symptoms questionnaire may suggest the possibility for the first step screening of DE with unstable tear film. Since the questionnaire has an overall poor sensitivity and specificity, further amelioration may be necessary for the actual utilization of this screening tool.

AB - Purpose. We determined whether functional visual acuity (VA) parameters and a dry eyes (DEs) symptoms questionnaire could predict DEs in a population of visual terminal display (VDT) users. Methods. This prospective study included 491 VDT users from the Osaka Study. Subjects with definite DE, diagnosed with the presence of DE symptoms, tear abnormality (Schirmer test ≤ 5 mm or tear breakup time [TBUT] ≤ 5 seconds), and conjunctivocorneal epithelial damage (total staining score of ≥3 points), or probable DE, diagnosed with the presence of two of them, were assigned to a DE group, and the remainder to a non-DE group. Functional VA was assessed, and DE questionnaires were administered. We assessed whether univariate and discriminant analyses could determine to which group a subject belonged. Sensitivity and specificity were assessed. Results. Of 491 subjects, 320 and 171 were assigned to the DE and non-DE groups, respectively. No significant differences were observed between DE and non-DE groups in Schirmer test value and epithelial damage, but TBUT value (3.1 ± 1.5 vs. 5.9 ± 3.0 seconds). The sensitivity and specificity of single test using functional VA parameters were 59% and 49% in functional VA, 60% and 50% in visual maintenance ratio, and 83% and 30% in frequency of blinking, respectively. According to a discriminant analysis using a combination of functional VA parameters and a DE questionnaire, six variables were selected for the discriminant equation, of which area under the curve (AUC) was 0.735. Sensitivity and specificity of diagnoses predicted by the discriminant equation were 85.9% and 45.6%, respectively. Conclusions. The discriminant equation obtained using functional VA measurement combined with a symptoms questionnaire may suggest the possibility for the first step screening of DE with unstable tear film. Since the questionnaire has an overall poor sensitivity and specificity, further amelioration may be necessary for the actual utilization of this screening tool.

KW - Dry eye

KW - Functional visual acuity

KW - Screening

KW - Tear break up time

KW - Visual display terminal user

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