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Changes in dry eye diagnostic status following implementation of revised Japanese dry eye diagnostic criteria

  • Clinical Investigation
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Abstract

Purpose

Our aim was to evaluate changes in dry eye diagnostic status following implementation of the new dry eye diagnostic criteria in Japan.

Design

This was a multicenter cross-sectional study.

Methods

We recruited 295 individuals (81 men, 214 women, average age 43.6 ± 14.3 years) seen for general ophthalmic checkup and dry eye examinations. Using results of the Schirmer I test, tear breakup time, and fluorescein and Rose Bengal staining, patients were diagnosed as having definite dry eye (DDE), probable dry eye (PDE), or as being normal according to both the old and new Japanese dry eye diagnostic criteria.

Results

Mean ages of normal participants and patients with PDE and DDE were 37.0 ± 10.4, 41.7 ± 14.4, and 47.7 ± 15.3 years, respectively (p < 0.001). All 37 individuals diagnosed as normal following the old criteria were also diagnosed as normal with the new diagnostic criteria. Among the 60 patients diagnosed as PDE with the old criteria, 19 (31.7%) were diagnosed as normal and 41 (68.3%) as PDE with the new diagnostic criteria. Of the 198 patients diagnosed with DDE following the old criteria, 59 (29.7%) were diagnosed as PDE and 139 (70.2%) as DDE with the new diagnostic criteria. There was no significant difference in dry eye severity index scores between the old and new diagnostic criteria.

Conclusion

A shift in the final dry eye diagnostic status from DDE to PDE and from PDE to normal was observed with the implementation of the new dry eye diagnostic criteria, suggesting that patients at the severe end of the dry eye disease spectrum are now diagnosed as DDE disease under the new criteria.

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References

  1. Lemp MA. Report of the National Eye Institute/Industry workshop on clinical trials in dry eyes. CLAO J. 1995;21:221–32.

    PubMed  CAS  Google Scholar 

  2. Lemp MA. Advances in understanding and managing dry eye disease. Am J Ophthalmol. 2008;146:350–6.

    Article  PubMed  Google Scholar 

  3. Onguchi T, Dogru M, Okada N, Kato NA, Tanaka M, Takano Y, et al. The impact of the onset time of atopic keratoconjunctivitis on the tear function and ocular surface findings. Am J Ophthalmol. 2006;141:569–71.

    Article  PubMed  Google Scholar 

  4. Shimazaki J. Definition and diagnosis of dry eye 1995. Ganka. 1995;37:765–70. (in Japanese).

    Google Scholar 

  5. Toda I, Fujishima H, Tsubota K. Ocular fatigue is the major symptom of dry eye. Acta Ophthalmol. 1993;71:347–52.

    Article  CAS  Google Scholar 

  6. The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of The International Dry Eye Work Shop (2007). Ocul Surf. 2007;5:75–92.

  7. Shimazaki J. Definition and diagnosis of dry eye 2006. Atarashii ganka. 2007;24:181–4. (in Japanese).

    Google Scholar 

  8. Schiffman RM, Christianson MD, Jacobsen G, Hirsch JD, Reis BL. Reliability and validity of the Ocular Surface Disease Index. Arch Ophthalmol. 2000;118:615–21.

    PubMed  CAS  Google Scholar 

  9. Toda I, Tsubota K. Practical double vital staining for ocular surface evaluation. Cornea. 1993;12:366–8.

    Article  PubMed  CAS  Google Scholar 

  10. van Bijsterveld OP. Diagnostic tests in the Sicca syndrome. Arch Ophthalmol. 1969;82:10–4.

    Article  PubMed  Google Scholar 

  11. Tsubota K. The importance of Schirmer test with nasal stimulation. Am J Ophthalmol. 1991;111:106–8.

    PubMed  CAS  Google Scholar 

  12. Roberts CB, Hiratsuka Y, Yamada M, Pezzullo ML, Yates K, Takano S, et al. Economic cost of visual impairment in Japan. Arch Ophthalmol. 2010;128:766–71.

    Article  PubMed  Google Scholar 

  13. Uchino M, Schaumberg DA, Dogru M, Uchino Y, Fukagawa K, Shimmura S, et al. Prevalence of dry eye disease among Japanese visual display terminal users. Ophthalmology. 2008;115:1982–8.

    Article  PubMed  Google Scholar 

  14. Uchino M, Dogru M, Uchino Y, Fukagawa K, Shimmura S, Takebayashi T, et al. Japan Ministry of Health study on prevalence of dry eye disease among Japanese high school students. Am J Ophthalmol. 2008;146:925–9.

    Article  PubMed  Google Scholar 

  15. Uchino M, Dogru M, Yagi Y, Goto E, Tomita M, Kon T, et al. The features of dry eye disease in a Japanese elderly population. Optom Vis Sci. 2006;83:797–802.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors thank Drs. Yoko Ogawa and Hiroshi Fujishima, Prof. Shigeru Kinoshita and Mr. Atushi Tsuyama for their assistance in recruiting participants.

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Authors and Affiliations

  1. Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan

    Yuichi Uchino & Miki Uchino

  2. Ryogoku Eye Clinic, Tokyo, Japan

    Miki Uchino & Kazuo Tsubota

  3. Johnson & Johnson Ocular Surface and Visual Optics Department, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan

    Murat Dogru & Samantha Ward

  4. Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Norihiko Yokoi

Authors
  1. Yuichi Uchino
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  2. Miki Uchino
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  3. Murat Dogru
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  4. Samantha Ward
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  5. Norihiko Yokoi
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  6. Kazuo Tsubota
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Corresponding author

Correspondence to Murat Dogru.

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Uchino, Y., Uchino, M., Dogru, M. et al. Changes in dry eye diagnostic status following implementation of revised Japanese dry eye diagnostic criteria. Jpn J Ophthalmol 56, 8–13 (2012). https://doi.org/10.1007/s10384-011-0099-y

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  • DOI: https://doi.org/10.1007/s10384-011-0099-y

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