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Chen J, Bai T, Su J, Cong X, Lv L, Tong L, Yu H, Feng Y, Yu G. Salivary Gland Transplantation as a Promising Approach for Tear Film Restoration in Severe Dry Eye Disease. J Clin Med 2024; 13:521. [PMID: 38256655 PMCID: PMC10816601 DOI: 10.3390/jcm13020521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/12/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
With increased awareness of dry eye disease (DED), a multitude of therapeutic options have become available. Nevertheless, the treatment of severe DED remains difficult. In a patient whose DED is related to the loss of lacrimal function without severe destruction of the salivary glands, autologous transplantation of the latter as functioning exocrine tissue to rebuild a stable tear film is an attractive idea. All three major and minor salivary glands have been used for such transplantation. Due to the complications associated with and unfavorable prognosis of parotid duct and sublingual gland transplantation, surgeons now prefer to use the submandibular gland (SMG) for such procedures. The transplantation of the SMG not only has a high survival rate, but also improves dry eye symptoms and signs for more than 20 years post-surgery. The regulation of the secretion of the transplanted SMG is critical because the denervated SMG changes its mechanism of secretion. Innovative procedures have been developed to stimulate secretion in order to prevent the obstruction of the Wharton's duct and to decrease secretion when postoperative "epiphora" occurs. Among the minor salivary glands, the transplantation of the labial salivary glands is the most successful in the long-term. The measurement of the flow rates of minor salivary glands and donor-site selection are critical steps before surgery.
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Affiliation(s)
- Jiayi Chen
- Beijing Key Laboratory of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China (H.Y.)
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Tianyi Bai
- Beijing Key Laboratory of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China (H.Y.)
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Jiazeng Su
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Xin Cong
- Key Laboratory of Molecular Cardiovascular Sciences, Beijing Key Laboratory of Cardiovascular Receptors Research, Department of Physiology and Pathophysiology, Peking University School of Basic Medical Sciences, Ministry of Education, Beijing 100191, China;
| | - Lan Lv
- Department of Ophthalmology, Beijing Tong Ren Hospital, Capital University of Medical Science, Beijing 100730, China
| | - Louis Tong
- Cornea and External Eye Disease Service, Singapore National Eye Center, Singapore 168751, Singapore;
- Ocular Surface Research Group, Singapore Eye Research Institute, Singapore 169856, Singapore
- Eye-Academic Clinical Program, Duke-National University of Singapore, Singapore 169857, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Haozhe Yu
- Beijing Key Laboratory of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China (H.Y.)
| | - Yun Feng
- Beijing Key Laboratory of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China (H.Y.)
| | - Guangyan Yu
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
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Lu YQ, Yang G, Li MY, Hong J, Yang YT, Wang XJ, Kong XH, Zhao Y, Ma Z, Huang XY, Zou YL, Zhou XT, Ma XP. Electroacupuncture for mild-to-moderate dry eye: study protocol for a multicentre, randomised, single-blind, sham-controlled trial. BMJ Open 2023; 13:e069369. [PMID: 38056935 PMCID: PMC10711924 DOI: 10.1136/bmjopen-2022-069369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 10/25/2023] [Indexed: 12/08/2023] Open
Abstract
INTRODUCTION Dry eye (DE) is a multifactorial ocular surface disease causing considerable medical, social and financial implications. Currently, there is no recognised long-term, effective treatment to alleviate DE. Clinical evidence shows that electroacupuncture (EA) can improve DE symptoms, tear secretion and tear film stability, but it remains controversial whether it is just a placebo effect. We aim to provide solid clinical evidence for the EA treatment of DE. METHODS AND ANALYSIS This is a multicentre, randomised, sham-controlled trial. A total of 168 patients with DE will be enrolled and randomly assigned to EA or sham EA groups to receive 4-week consecutive treatments and follow-up for 24 weeks. The primary outcome is the change in the non-invasive tear break-up time (NIBUT) from baseline to week 4. The secondary outcomes include tear meniscus height, the Schirmer I test, corneal and conjunctival sensation, the ocular surface disease index, corneal fluorescein staining, the numerical rating scale and the Chinese DE-related quality of life scale. ETHICS AND DISSEMINATION The trial protocol and informed consent were approved by the Ethics Committee of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine (identifier: 2021-119), Shanghai Eye Disease Prevention and Treatment Center (identifier: 2022SQ003) and Eye and ENT Hospital of Fudan University (identifier: 2022014). TRIAL REGISTRATION NUMBER NCT05552820.
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Affiliation(s)
- Yun-Qiong Lu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guang Yang
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
| | - Mei-Yan Li
- Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Jue Hong
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
| | - Yan-Ting Yang
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
| | - Xue-Jun Wang
- Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Xie-He Kong
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yue Zhao
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
| | - Zhao Ma
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xin-Yun Huang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yue-Lan Zou
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
| | - Xing-Tao Zhou
- Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Xiao-Peng Ma
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
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Le DTM, Kandel H, Watson SL. Evaluation of ocular neuropathic pain. Ocul Surf 2023; 30:213-235. [PMID: 37748645 DOI: 10.1016/j.jtos.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 09/27/2023]
Abstract
AIM To identify and assess the quality of current validated questionnaires that could be used to evaluate ocular neuropathic pain and its associated aetiologies. METHODS A literature search was performed on MEDLINE, PubMed, EMBASE, PsycINFO and The Cochrane Library. Articles evaluating questionnaires for ocular neuropathic pain and its associated aetiologies were included. Data on psychometric properties, validity, and reliability of the questionnaires was extracted and analysed using a set of quality criteria. Clinical and demographical associations with ocular neuropathic pain were also reviewed. RESULTS The search generated 1738 results with 61 publications meeting the inclusion criteria. The 61 publications covered 28 questionnaires including 3 ocular pain, 12 dry eye disease, 2 blepharitis, 2 refractive surgery, 3 contact lens wear, 3 Sjogren's Syndrome, and 3 that were non-disease-specific. Only 57 publications provided enough data on psychometric properties and validity of the questionnaire to be included for quality assessment. The Contact Lens Discomfort Index (CLDI) had the highest rated psychometric properties, whereas the English version of the Ocular Comfort Index (OCI) provided the most data on psychometric properties (9 out of 10 criteria). Most ocular pain and disease-specific questionnaires contained appropriate items to assess ocular pain in specific populations. However, non-disease-specific ophthalmic questionnaires demonstrated poor reliability and validity when evaluating ocular pain. CONCLUSION Ocular pain questionnaires can potentially diagnose ocular neuropathic pain. Disease-specific questionnaires were limited to their target populations, and non-disease-specific ophthalmic questionnaires were unreliable. Further studies are required to determine the most appropriate questionnaire to evaluate ocular neuropathic pain.
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Affiliation(s)
- Damien Tuan-Man Le
- The University of Sydney, Save Sight Institute, Sydney, NSW, 2000, Australia; Sydney Eye Hospital, Sydney, NSW, 2000, Australia.
| | - Himal Kandel
- The University of Sydney, Save Sight Institute, Sydney, NSW, 2000, Australia; Sydney Eye Hospital, Sydney, NSW, 2000, Australia
| | - Stephanie L Watson
- The University of Sydney, Save Sight Institute, Sydney, NSW, 2000, Australia; Sydney Eye Hospital, Sydney, NSW, 2000, Australia
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Chen Y, Wu Y, Gao M, Gao R, Zhang K. Differential response to topical lubrication in patient with dry eye disease, based on age. BMC Ophthalmol 2022; 22:396. [PMID: 36199043 PMCID: PMC9532823 DOI: 10.1186/s12886-022-02609-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/09/2022] [Accepted: 09/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To compare the Ocular surface disease index (OSDI) score, Schirmer I test (SIT), fluorescein break up time (FBUT) and fluorescence staining (FLCS) score of dry eye patients at different ages. METHODS 90 eyes of 90 patients with mild to moderate dry eye from September 2020 to September 2021 were retrospectively included and were divided into young group (20-39 years, n = 29), middle-age group (40-59 years, n = 30), and elder group (> 60 years, n = 31). Patients were given a 28-day topical lubricating ocular surface and repair-promoting drugs combined with local physical therapy. Patients were followed up at 7, 14 and 28 days. The OSDI score, SIT, FBUT and FLCS score were examined. RESULTS There were differences between the OSDI score in three groups at each time point (all P < 0.001). SIT were different among the three groups (F = 350.61, P < 0.001), and a time effect was found (F = 80.87, P < 0.001). SIT at 14 and 28 days after treatment in middle-age and elder groups were lower than young group (all P < 0.001). SIT at 7, 14 and 28 days in elder group were lower than middle-age group (all P < 0.001). FLCS score was lower at 28 days than other time points (all P < 0.001). CONCLUSION Dry eye patients are given a 28-day topical lubricating ocular surface and repair-promoting drugs combined with local physical therapy, which can promote tear secretion, film stability, and the recovery of corneal integrity. Age affects the treatment effect of mild to moderate dry eye, among which tear secretion is the most significant.
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Affiliation(s)
- Yingxin Chen
- Department of ophthalmology, the General Hospital of Northern Theater Command, No.83, Wenhua Road, Shenhe District, 110840, Shenyang, China
| | - Yajun Wu
- Department of ophthalmology, the General Hospital of Northern Theater Command, No.83, Wenhua Road, Shenhe District, 110840, Shenyang, China
| | - Minghong Gao
- Department of ophthalmology, the General Hospital of Northern Theater Command, No.83, Wenhua Road, Shenhe District, 110840, Shenyang, China.
| | - Ruiyao Gao
- Department of ophthalmology, the General Hospital of Northern Theater Command, No.83, Wenhua Road, Shenhe District, 110840, Shenyang, China
| | - Kai Zhang
- Department of ophthalmology, the General Hospital of Northern Theater Command, No.83, Wenhua Road, Shenhe District, 110840, Shenyang, China
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Tananuvat N, Tansanguan S, Wongpakaran N, Wongpakaran T. Reliability, validity, and responsiveness of the Thai version of the Dry Eye-Related Quality-of-Life Score questionnaire. PLoS One 2022; 17:e0271228. [PMID: 35852996 PMCID: PMC9295941 DOI: 10.1371/journal.pone.0271228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 06/25/2022] [Indexed: 11/29/2022] Open
Abstract
Dry eye disease (DED) is a common and growing eye problem worldwide. Chronic DED symptoms can, subsequently, affect the patients’ quality of life (QOL). This prospective cross-sectional study aimed to assess the reliability, validity, and responsiveness of the Thai version of the Dry Eye-Related Quality-of-Life Score (DEQS-Th) questionnaire and to evaluate its accuracy in DED screening. Psychometric validation was conducted on DED participants. All participants completed the DEQS-Th and other measurements including the Ocular Surface Disease Index (OSDI) and the 5-level EQ-5D (EQ-5D-5L). Internal consistency, concurrent validity, convergent, and discriminant validity were evaluated. The standardized response mean (SRM) was used to evaluate the responsiveness of the DEQS-Th. The optimal cut-off score of DEQS-Th for DED screening was assessed. Among 100 participants with a mean age of 50.9 ± 14.4 years, and 89.0% female, the internal consistency of the DEQS-Th was excellent (Cronbach’s alpha: 0.80–0.92). The test-retest intraclass correlation was 0.82–0.92. It showed concurrent validity with the OSDI (r = 0.694, p < .001) and EQ-5D-5L index scores (r = -0.578, p < .001). DED is suspected if the DEQS-Th score ≥ 18.33 (AUC = 0.897, sensitivity 90.0%, specificity 76.7%) or its Short Form score ≥ 3 (AUC 0.857, sensitivity 93.0%, specificity 63.3%). The SRM of the symptom subscale of DEQS-Th was 0.82, indicating relatively large responsiveness, whereas the impact on daily life subscale and the summary score was small. In conclusion, the DEQS-Th is valid and reliable for evaluating the multifaceted effects of DED on a patient’s QOL. It can be useful for primary assessment and monitoring of DED in routine clinical practice.
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Affiliation(s)
- Napaporn Tananuvat
- Faculty of Medicine, Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand
- * E-mail:
| | - Sasiwimon Tansanguan
- Faculty of Medicine, Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand
| | - Nahathai Wongpakaran
- Faculty of Medicine, Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
| | - Tinakon Wongpakaran
- Faculty of Medicine, Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
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Liu S, Li S, Li M, Zeng S, Chen B, Zhang L. Evaluation of the Ocular Surface and Meibomian Gland in Obstructive Sleep Apnea Hypopnea Syndrome. Front Med (Lausanne) 2022; 9:832954. [PMID: 35223929 PMCID: PMC8863666 DOI: 10.3389/fmed.2022.832954] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 01/14/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose To assess the ocular surface and meibomian gland (MG) of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and to explore the effects of surgery for OSAHS on the ocular surface and MG. Methods Based on the apnea hypopnea index (AHI), 21 patients with mild OSAHS (Group A, 5/h ≤ AHI < 15/h), 20 patients with moderate OSAHS (Group B, 15/h ≤ AHI < 30/h), 62 patients with severe OSAHS (Group C, AHI ≥ 30/h) were examined. The ocular surface and MG were evaluated using Keratograph 5M. In addition, detailed Ophthalmic examination including visual acuity, refraction, slit-lamp examination of the anterior segment, corneal fluorescein staining (CFS), ocular surface disease index (OSDI) scoring, Schirmer I test (SIT) and serum lipid measurement was performed. For OSAHS patients with dry eye syndrome (DES) who underwent uvulopalatopharyngoplasty for improving AHI, the conditions of the ocular surface and MG were compared before surgery and 3 months after surgery. Only the data of the right eyes were analyzed. Results There were no significantly different in the OSDI score, tear meniscus height (TMH), or loss ratio of the lower eyelid (LRLE) among these groups. The first non-invasive tear film breakup time (fNIBUT), average non-invasive tear film breakup time (avNIBUT), bulbar redness index (BRI), lipid layer grading (LLG), CFS, plugged orifices and distortion in MG, the loss ratio of upper eyelid (LRUE), and the incidence of DES, floppy eyelid syndrome (FES) and meibomian gland dysfunction (MGD) showed significant differences between Groups A and C (p = 0.015, p = 0.018, p < 0.001, p = 0.022, p = 0.036, p = 0.007, p = 0.019, p = 0.017, p = 0.045, p = 0.013, and p = 0.029, respectively). The SIT in the Group A was significantly higher than in Group B (p = 0.025) and in Group C (p < 0.001). In the correlation analyses, the fNIBUT, avNIBUT, SIT and LLG had negative correlations with the AHI (p = 0.013, p = 0.010, p = 0.003, p < 0.001, and p = 0.006, respectively). The BRI, CFS and LRUE were positively correlated with the AHI (p = 0.006, p = 0.007, and p = 0.046, respectively). Three months after surgery, there were no significant differences in the ocular surface or MG. Conclusion Patients with severe OSAHS have poor stability of tear film and are prone to lipid-deficient dry eye as a result of the loss of meibomian gland. By improving the AHI, the ocular surface damage of OSAHS patients cannot be reversed in a short time.
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Affiliation(s)
- Shaohua Liu
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Clinical Research Centre of Ophthalmic Disease, Changsha, China
| | - Shisheng Li
- Department of Otorhinolaryngology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Mengmeng Li
- Department of Otorhinolaryngology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shiying Zeng
- Department of Otorhinolaryngology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Baihua Chen
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Clinical Research Centre of Ophthalmic Disease, Changsha, China
| | - Liwei Zhang
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Clinical Research Centre of Ophthalmic Disease, Changsha, China
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Tansanguan S, Tananuvat N, Wongpakaran N, Wongpakaran T, Ausayakhun S. Thai version of the dry eye-related quality-of-life score questionnaire: preliminary assessment for psychometric properties. BMC Ophthalmol 2021; 21:310. [PMID: 34454466 PMCID: PMC8400753 DOI: 10.1186/s12886-021-02077-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 08/13/2021] [Indexed: 01/02/2023] Open
Abstract
Background This study aimed to develop a Thai version of the Dry Eye–Related Quality-of-Life Score (DEQS-Th) questionnaire and evaluate its validity, reliability, and feasibility among Thai participants. Methods The DEQS-Th, a 15-item self-report measuring dry eye and its impact on quality of life (QOL) was developed based on the DEQS. The questionnaire was divided into two subscales: Bothersome Ocular Symptoms (six questions), and Impact on Daily Life (nine questions). It employed a 5-point Likert scale, addressing on both the frequency and the degree of symptoms. Backward and forward and cultural adaptation process translation methods were employed. Thirty healthy participants were enrolled to evaluate the feasibility of the DEQS-Th in terms of difficulty and convenience. Reliability was assessed using internal consistency determined by Cronbach’s alpha, with values > 0.7 considered acceptable. Convergent validity was determined by the correlation between DEQS-Th and overall health status. Confirmatory factor analysis was conducted for its factor structure. Results The participants’ mean age was 38.6 ± 12.9 years, and 23 (76.7%) were females. The mean time to complete the questionnaire was 9.3 ± 2.7 min. The Cronbach’s alpha of the ocular symptoms subscale, impact on QOL subscale, and summary score on frequency and degree were 0.80 and 0.70, 0.89 and 0.89, and 0.90 and 0.89, respectively. The overall health status significantly correlated with the summary score (r = 0.564, p = .001), subscale ocular symptoms (r = 0.594, p = .001), and impact on QOL scores (r = 0.626, p < .001) of the DEQS-Th, respectively. A one-factor model fitted the data the best for both the ocular symptoms subscale (CFI = 1.000, TLI = 1.000, RMSEA = 0.000) and the impact on QOL subscale (CFI = 0.998, TLI = 0.997, RMSEA = 0.053). Conclusion When tested among normal participants, the DEQS-Th is a valid and reliable measurement for dry eye symptoms and impact on QOL. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-02077-0.
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Affiliation(s)
- Sasiwimon Tansanguan
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Napaporn Tananuvat
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Nahathai Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Somsanguan Ausayakhun
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
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A systematic review assessing the quality of patient reported outcomes measures in dry eye diseases. PLoS One 2021; 16:e0253857. [PMID: 34370748 PMCID: PMC8351938 DOI: 10.1371/journal.pone.0253857] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 06/14/2021] [Indexed: 11/19/2022] Open
Abstract
Background Patient-reported outcome measures (PROMs) can provide valuable insights on the impact of a disease or treatment on a patient’s health-related quality of life. In ophthalmology, particularly in dry eye disease (DED) and ocular surface disease (OSD), it is unclear whether the available PROMs were developed using comprehensive guidelines. To address this, we evaluated the methodological quality of studies assessing the psychometric properties of PROMs in DED and OSD [PROSPERO registration number CRD42019142328]. Methods Four databases were searched; reference list and citation searching of included studies was also conducted. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used to appraise the quality of the studies evaluating the psychometric properties of PROMs used in DED and OSD. Results The search strategy (S3 Table) retrieved 5,761 records, 573 duplicates were removed, 5,188 abstracts were screened and 127 full-text articles were retrieved for further review. Of these, 118 full-text articles did not meet the eligibility criteria and were excluded. Reference list and citation searching, identified an additional 8 articles bringing the total numbers of papers reviewed to 17. In general, psychometric properties such as content validity, measurement error and structural validity were not assessed by the studies included in this review. Studies reviewing The Impact of Dry Eye on Everyday Life (IDEEL) presented with the highest quality scores together with the Ocular Surface Disease Index (OSDI) questionnaire. Conclusions The quality of studies evaluating PROMs in DED and OSD was considered using the COSMIN standards. The majority of the studies evaluating PROMs included in this review did not meet the recommended COSMIN criteria and the quality of the PROMs evaluated is not assured. Further evaluation of their psychometric properties is required if these are going to be used in clinical practice or research.
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A Review of Dry Eye Questionnaires: Measuring Patient-Reported Outcomes and Health-Related Quality of Life. Diagnostics (Basel) 2020; 10:diagnostics10080559. [PMID: 32764273 PMCID: PMC7459853 DOI: 10.3390/diagnostics10080559] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/21/2020] [Accepted: 08/03/2020] [Indexed: 02/07/2023] Open
Abstract
Dry eye disease (DED) is among the most common eye diseases and is becoming increasingly prevalent. Its symptoms cause a long-term decline in patients’ health-related quality of life (HRQL). Inconsistencies often occur between the clinical findings and the subjective symptoms of DED. Therefore, a holistic, balanced, and quantitative evaluation of the subjective symptoms and HRQL using patient-reported outcome questionnaires, in addition to clinical findings, is crucial for accurate DED assessment in patients. This paper reviewed the characteristics of current dry eye questionnaires, including their objectives, number of questions, inclusion of HRQL-related items, and whether they were properly evaluated for psychometric properties. Twenty-four questionnaires were identified; among them, the following six questionnaires that included items assessing HRQL and were properly evaluated for psychometric properties are recommended: the Ocular Surface Disease Index, Impact of Dry Eye in Everyday Life, Dry Eye-Related Quality-of-life Score, University of North Carolina Dry Eye Management Scale, Chinese version of Dry Eye-Related Quality of Life, and 25-Item National Eye Institute Visual Function Questionnaire. Dry eye questionnaires have different objectives and are available in different languages. Therefore, medical practitioners should confirm the characteristics of applicable questionnaires before selecting the most appropriate ones.
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Midorikawa-Inomata A, Inomata T, Nojiri S, Nakamura M, Iwagami M, Fujimoto K, Okumura Y, Iwata N, Eguchi A, Hasegawa H, Kinouchi H, Murakami A, Kobayashi H. Reliability and validity of the Japanese version of the Ocular Surface Disease Index for dry eye disease. BMJ Open 2019; 9:e033940. [PMID: 31772113 PMCID: PMC6886996 DOI: 10.1136/bmjopen-2019-033940] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES The Ocular Surface Disease Index (OSDI) questionnaire is widely used to evaluate subjective symptoms of dry eye disease (DED) as a primary diagnostic criterion. This study aimed to develop a Japanese version of the OSDI (J-OSDI) and assess its reliability and validity. DESIGN AND SETTING Hospital-based cross-sectional observational study. PARTICIPANTS A total of 209 patients recruited from the Department of Ophthalmology at Juntendo University Hospital. METHODS We translated and culturally adapted the OSDI into Japanese. The J-OSDI was then assessed for internal consistency, reliability and validity. We also evaluated the optimal cut-off value to suspect DED using an area under the receiver operating characteristic curve (AUC) analysis. PRIMARY OUTCOME MEASURES Internal consistency, test-retest reliability and discriminant validity of the J-OSDI as well as the optimal cut-off value to suspect DED. RESULTS Of the participants, 152 had DED and 57 did not. The J-OSDI total score showed good internal consistency (Cronbach's alpha=0.884), test-retest reliability (interclass correlation coefficient=0.910) and discriminant validity by known-group comparisons (non-DED, 19.4±16.0; DED, 37.7±22.2; p<0.001). Factor validity was used to confirm three subscales within the J-OSDI according to the original version of the questionnaire. Concurrent validity was assessed by Pearson correlation analysis, and the J-OSDI total score showed a strong positive correlation with the Dry Eye-Related Quality-of-Life Score (γ=0.829). The optimal cut-off value of the J-OSDI total score was 36.3 (AUC=0.744). CONCLUSIONS The J-OSDI was developed and validated in terms of reliability and validity as an effective tool for DED assessment and monitoring in the Japanese population.
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Affiliation(s)
- Akie Midorikawa-Inomata
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Takenori Inomata
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Ophthalmology, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Strategic Operating Room Management and Improvement, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Shuko Nojiri
- Department of Medical Technology Center, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Masahiro Nakamura
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Masao Iwagami
- Department of Health Services Research, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Keiichi Fujimoto
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Yuichi Okumura
- Department of Strategic Operating Room Management and Improvement, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Nanami Iwata
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Atsuko Eguchi
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Hitomi Hasegawa
- Department of Ophthalmology, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Hikaru Kinouchi
- School of Cultural and Creative Studies, Aoyama Gakuin University, Shibuya-ku, Tokyo, Japan
| | - Akira Murakami
- Department of Ophthalmology, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Hiroyuki Kobayashi
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
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Su JZ, Zheng B, Liu XJ, Xie Z, Sun D, Cai ZG, Lv L, Yu GY. Quality of life and patient satisfaction after submandibular gland transplantation in patients with severe dry eye disease. Ocul Surf 2019; 17:470-475. [DOI: 10.1016/j.jtos.2019.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 04/12/2019] [Accepted: 04/17/2019] [Indexed: 01/19/2023]
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Zi Y, Ji M, Deng Y, Qin Y, Wang R, Meng H, Jin M. The effectiveness and safety of moxibustion for dry eye: Protocol for a systematic review. Medicine (Baltimore) 2019; 98:e15178. [PMID: 30985705 PMCID: PMC6485804 DOI: 10.1097/md.0000000000015178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Dry eye (DE) is a common type of ocular surface disease that affects many people. Moxibustion has been widely used in China to treat ocular surface diseases, especially DE. Many clinical trials have demonstrated that moxibustion can increase the tear secretion quantity and improve tear film stability. The purpose of this review is to provide an objective and normative systematic review to evaluate the effectiveness and safety of moxibustion treatment in patients with DE. METHODS The systematic review will include all of the randomized controlled trials on the effectiveness and safety of moxibustion for DE. Nine medical databases, namely PubMed, EMBASE, the Cochrane Library, Google Scholar, Web of Science, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal database (VIP), Wanfang Database, and CBM, will be searched from the date of the database inception to February 28, 2019. We will also search registers of clinical trials, potential gray literature, and conference abstracts. There are no restrictions on language and publication status. Two reviewers will independently select studies, and extract and manage data. The reporting quality and risk of bias will be assessed by other 2 review authors. The primary outcomes will include ocular surface disease index (OSDI) scores, Schirmer test (SIT) results, tear meniscus height (TMH), and tear break-up time (TBUT) values. Quality of life, the main symptom scores before and after treatment, meibomian gland (MG) morphology, total treatment efficacy, and safety will be evaluated as the secondary outcomes. We will use RevMan V.5.3 software to synthesize and analyze data. RESULTS This systematic review will provide a comprehensive review of current evidence of moxibustion for DE from the following aspects: the OSDI, SIT, TMH, BUT, quality of life, the main symptom scores, MG morphology, total treatment efficacy, and safety. CONCLUSION The conclusion of our systematic review will provide evidence to determine whether moxibustion is an effective and safe intervention for patients with DE. ETHICS AND DISSEMINATION Since patients will not be involved in this study, it is not necessary to obtain ethical approval. The protocol and results will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER PROSPERO CRD42018097399.
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Affiliation(s)
- Yingxin Zi
- Beijing University of Chinese Medicine
- Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China
| | - Meiqi Ji
- Beijing University of Chinese Medicine
- Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China
| | - Yu Deng
- Beijing University of Chinese Medicine
- Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China
| | - Yali Qin
- Beijing University of Chinese Medicine
- Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China
| | - Rui Wang
- Beijing University of Chinese Medicine
- Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China
| | - Huan Meng
- Beijing University of Chinese Medicine
- Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China
| | - Ming Jin
- Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China
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Akkaya S. The Effect of Artificial Tear Preparations with Three Different Ingredients on Contrast Sensitivity in Patients with Dry Eye Syndrome. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2018; 7:89-93. [PMID: 30250858 PMCID: PMC6146240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This study was conducted to investigate the effects of Artificial Tear Preparations (ATP) with three different ingredients on contrast sensitivity in patients with dry eye syndrome. Contrast sensitivity measurements were obtained before and 5, 15, 30, 60, and 90 minutes after administering three different ATPs, containing dextran 70, hydroxypropyl methylcellulose (ATP-1), polyvinyl alcohol-povidone (ATP-2) and carbomer (ATP-3) to one eye of 20 patients with dry eye syndrome, who had been divided to three groups. Contrast sensitivity measurements were obtained at 1.5, 3, 6, 12, and 18 spatial frequencies (cpd). Compared with the baseline measurements, ATP-1 provided a significant increase of 1.5 and 3 cpd at the 15th minute, 12 cpd at the 60th minute, and 18 cpd at the 30th minute, ATP-2 significantly increased contrast sensitivity compared with the baseline at the 15th, 30th, 60th, and 90th minute measurements, recorded as 1.5, 3, 12, and 18 cpd, and ATP-3 provided significant increases of 18 cpd at 60th and 90th minute measurements compared with the baseline. In conclusion, while ATP-2 increased the majority of contrast sensitivity measurements both at early, mid, and late terms, the ATP-1 and ATP-3 were found to be effective on mid-term and late-term contrast sensitivity measurements, respectively.
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Affiliation(s)
- Sezen Akkaya
- Fatih Sultan Mehmet Education and Training Hospital, Ophthalmology Clinics, Bostancı, Istanbul, Turkey
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