评估干眼症体征和症状的高科技参数:临床临界值的确定及与低技术测试的一致性。

IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Ophthalmology and Therapy Pub Date : 2024-11-01 Epub Date: 2024-09-28 DOI:10.1007/s40123-024-01034-6
Paolo Fogagnolo, Pasquale Aragona, Alfonso Strianese, Edoardo Villani, Giuseppe Giannaccare, Vincenzo Orfeo, Valentina Mirisola, Rita Mencucci
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引用次数: 0

摘要

导言:用于评估干眼症(DED)的高科技设备越来越多。然而,迄今为止,人们对高科技和低科技参数之间的一致性还缺乏深入研究。为了填补这些空白,我们对最近发表的一项回顾性研究进行了事后分析,研究对象是同时接受低科技和高科技(Keratograph®)评估以及不同润滑眼药水治疗的干眼症患者:作者根据文献空白和临床经验确定了六个临床问题,即:(1) NIKBUT-i 和 T-BUT 参数是否可以互换?(2)在未经治疗和已治疗的 DED 患者中,低技术参数和高技术参数之间的相关性如何?(3) 基线和治疗期间/之后的体征和症状之间的相关性如何?(4) 哪些参数与症状更相关?以及症状随时间的变化?(5) NIKBUT-i 和 T-BUT 在检测临床相关变化方面的性能如何?(6) 在 NIKBUT-i 和 T-BUT 的基础上分别增加其他高技术和低技术参数的临床优势是什么?低技术指标是基线眼表疾病指数(OSDI)的最佳描述指标。相比之下,高科技评估在检测随时间推移的变化方面表现更佳。在基线和随访期间,NIKBUT-i 数据的分布比 TBUT 更为分散。在特异性固定为 80% 的情况下,NIKBUT-i 检测临床相关症状改善的灵敏度为 42%,T-BUT 为 25%。一组高科技测试可检测出 90% 的临床症状改善,而低科技测试仅能检测出 45% 的临床症状改善(p 结论:低科技测试足以诊断症状改善:低技术检测足以用于 DED 的诊断,而高科技检测在随访中的表现更好,特别是当不同检测组合在一起时。总体而言,高、低技术评估参数之间的互换性较差,与症状的一致性也较差。
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High-Tech Parameters for the Evaluation of Signs and Symptoms of Dry Eye Disease: Identification of Clinical Cut-Offs and Agreement with Low-Tech Tests.

Introduction: High-tech devices for the assessment of dry eye disease (DED) are increasingly available. However, the agreement between high- and low-tech parameters has been poorly explored to date. Trying to fill these gaps, we conducted a post hoc analysis on a recently published retrospective study on patients with DED receiving both low- and high-tech (Keratograph®) assessments, and treatment with different lubricating eyedrops.

Methods: Six clinical questions were defined by the authors, considering literature gaps and their clinical experience, namely: (1) are NIKBUT-i and T-BUT interchangeable parameters? (2) What was the correlation between low- and high-tech parameters in untreated and treated patients with DED? (3) What was the correlation between signs and symptoms at baseline and during/after treatment? (4) Which parameters were better associated with symptoms? And with symptoms change over time? (5) What was the performance of NIKBUT-i and T-BUT in detecting clinically relevant changes? (6) What was the clinical advantage of adding other high- and low-tech parameters, respectively, to NIKBUT-i and T-BUT?

Results: Low-tech measures were the best descriptors of the Ocular Surface Disease Index (OSDI) at baseline. In contrast, high-tech assessments demonstrate better performance in detecting changes over time. The distribution of NIKBUT-i data was more dispersed than TBUT both at baseline and follow-up. At a fixed specificity of 80%, the sensitivity in detecting clinically relevant ameliorations of symptoms was 42% for NIKBUT-i and 25% for T-BUT. A battery of high-tech tests could detect 90% of clinical amelioration, compared with 45% with low-tech tests (p < 0.001). Correlation between low- and high-tech parameters in both treated and untreated patients is lacking.

Conclusions: Low-tech measures are adequate for diagnostic purposes in DED, whereas high-tech showed better performances at follow-up, particularly when different tests are combined. Overall, poor interchangeability among parameters and agreement with symptoms was reported both with high- and low-tech assessments.

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Ophthalmology and Therapy
Ophthalmology and Therapy OPHTHALMOLOGY-
CiteScore
4.20
自引率
3.00%
发文量
157
审稿时长
6 weeks
期刊介绍: Aims and Scope Ophthalmology and Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from preclinical, clinical (all phases), observational, real-world, and health outcomes research around the use of ophthalmological therapies, devices, and surgical techniques. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Ophthalmology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. 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