PMID- 24848115
OWN - NLM
STAT- MEDLINE
DCOM- 20150115
LR  - 20240322
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 9
IP  - 5
DP  - 2014
TI  - Comparison of diagnostic tests in distinct well-defined conditions related to dry 
      eye disease.
PG  - e97921
LID - 10.1371/journal.pone.0097921 [doi]
LID - e97921
AB  - PURPOSE: This study compares signs, symptoms and predictive tools used to 
      diagnose dry eye disease (DED) and ocular surface disorders in six systemic 
      well-defined and non-overlapping diseases. It is well known that these tests are 
      problematic because of a lack of agreement between them in identifying these 
      conditions. Accordingly, we provide here a comparative clinical profile analysis 
      of these different diseases. METHODS: A spontaneous and continuous sample of 
      patients with Sjogren's syndrome (SS) (n=27), graft-versus-host-disease (GVHD) 
      (n=28), Graves orbitopathy (n=28), facial palsy (n=8), diabetes mellitus without 
      proliferative retinopathy (n=14) and glaucoma who chronically received topical 
      drugs preserved with benzalkonium chloride (n=20) were enrolled. Evaluation 
      consisted of a comprehensive protocol encompassing: (1) structured questionnaire 
      - Ocular Surface Disease Index (OSDI); (2) tear osmolarity (TearLab Osmolarity 
      System - Ocusense); (3) tear film break-up time (TBUT); (4) fluorescein and 
      lissamine green staining; (5) Schirmer test and (6) severity grading. RESULTS: 
      One hundred and twenty five patients (aged 48.8 years-old +/- 14.1, male:female 
      ratio=0.4) were enrolled in the study, along with 24 age and gender matched 
      controls. Higher scores on DED tests were obtained in Sjogren Syndrome (P<0.05), 
      except for tear film osmolarity that was higher in diabetics (P<0.001) and 
      fluorescein staining, that was higher in facial palsy (P<0.001). TFBUT and OSDI 
      correlated better with other tests. The best combination of diagnostic tests for 
      DED was OSDI, TBUT and Schirmer test (sensitivity 100%, specificity 95% and 
      accuracy 99.3%). CONCLUSIONS: DED diagnostic test results present a broad range 
      of variability among different conditions. Vital stainings and TBUT correlated 
      best with one another whereas the best test combination to detect DED was: 
      OSDI/TBUT/Schirmer.
FAU - Alves, Monica
AU  - Alves M
AD  - Faculty of Medicine Ribeirao Preto, Sao Paulo University, Ribeirao Preto, SP, 
      Brazil; Pontific Catholic University of Campinas, Campinas, SP, Brazil.
FAU - Reinach, Peter Sol
AU  - Reinach PS
AD  - Faculty of Medicine Ribeirao Preto, Sao Paulo University, Ribeirao Preto, SP, 
      Brazil.
FAU - Paula, Jayter Silva
AU  - Paula JS
AD  - Faculty of Medicine Ribeirao Preto, Sao Paulo University, Ribeirao Preto, SP, 
      Brazil.
FAU - Vellasco e Cruz, Antonio Augusto
AU  - Vellasco e Cruz AA
AD  - Faculty of Medicine Ribeirao Preto, Sao Paulo University, Ribeirao Preto, SP, 
      Brazil.
FAU - Bachette, Leticia
AU  - Bachette L
AD  - Faculty of Medicine Ribeirao Preto, Sao Paulo University, Ribeirao Preto, SP, 
      Brazil.
FAU - Faustino, Jacqueline
AU  - Faustino J
AD  - Faculty of Medicine Ribeirao Preto, Sao Paulo University, Ribeirao Preto, SP, 
      Brazil.
FAU - Aranha, Francisco Penteado
AU  - Aranha FP
AD  - Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
FAU - Vigorito, Afonso
AU  - Vigorito A
AD  - Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
FAU - de Souza, Carmino Antonio
AU  - de Souza CA
AD  - Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
FAU - Rocha, Eduardo Melani
AU  - Rocha EM
AD  - Faculty of Medicine Ribeirao Preto, Sao Paulo University, Ribeirao Preto, SP, 
      Brazil.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140521
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Diagnostic Tests, Routine/*methods
MH  - Dry Eye Syndromes/*complications/*diagnosis
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Sensitivity and Specificity
PMC - PMC4029783
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2014/05/23 06:00
MHDA- 2015/01/16 06:00
PMCR- 2014/05/21
CRDT- 2014/05/23 06:00
PHST- 2013/11/29 00:00 [received]
PHST- 2014/04/27 00:00 [accepted]
PHST- 2014/05/23 06:00 [entrez]
PHST- 2014/05/23 06:00 [pubmed]
PHST- 2015/01/16 06:00 [medline]
PHST- 2014/05/21 00:00 [pmc-release]
AID - PONE-D-13-50420 [pii]
AID - 10.1371/journal.pone.0097921 [doi]
PST - epublish
SO  - PLoS One. 2014 May 21;9(5):e97921. doi: 10.1371/journal.pone.0097921. eCollection 
      2014.