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Tool accurately assesses dry eye disease risk

An investigation into the Dry Eye Risk Assessment (DERA) tool has found it can accurately identify patients at risk of the disease.

The findings were based on a study conducted by the Association for Research in Vision and Ophthalmology (ARVO), which used DERA and the Dry Eye Questionnaire (DEQ-5) with patients at 11 clinical sites. According to medical news site Healio, the results showed it worked as a standalone tool, with sensitivity at 87% and specificity at 74%.

For the tests, each investigator was masked to initial responses and allowed to choose at least one clinical test – such as tear break-up time, Efron corneal or conjunctival staining, meibomian gland expression quality, and phenol red thread test – to qualify the subject as dry or normal.

"DERA is essentially a calculator that is able to predict dry eye by symptoms (DEQ-5) and one clinical sign 76.2% of the time."
Justin Kwan, Lead researcher

Participants had an average age of 50.7 years, and were classified according to the Dry Eye Workshop II definitions; normal, dry eye disease, signs without symptoms (predisposition) or symptoms without signs (preclinical).

The researchers found a 72.8% agreement between investigator opinion and DERA. In cases where symptoms derived from DEQ-5 and at least one sign were used, agreement between that diagnosis and DERA was 76.2%.

Using the DEQ-5 responses, patients were graded as 22 normal subjects, 38 subjects with a score of at least six and less than 12, and 27 participants with a score of at least 12. Based on the DEWS II guidelines there were 10 normal subjects, 64 with dry eye disease, nine subjects with predisposition and one as preclinical, while DERA identified 71 subjects at risk. 

“Traditionally, risk factors for dry eye are either consistent, probably or inconclusive,” lead researcher Dr Justin Kwan told Primary Care Optometry News.

“Calculators exist for coronary heart disease and glaucoma, for instance. After refining a new set of risk factor questions, the five items that remain were age, seeing a doctor regularly, sinus issues, migraines and use of eye drops.”

As a result of the study, the team suggested that DERA could be used as a powerful dry eye risk calculator.

“DERA is essentially a calculator that is able to predict dry eye by symptoms (DEQ-5) and one clinical sign 76.2% of the time. This has applications in primary care and screening settings or in an eyecare provider’s clinic as well,” Kwan added.

Image courtesy: Flickr | Perfectionist Reviews

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