DREAM study highlights variability in dry eye disease symptom measurements

In patients with moderate-to-severe dry eye disease (DED), measurements of DED signs and symptoms show moderate repeatability, with significant variability between visits, according to a study.

Researchers assessed dry eye disease (DED) symptoms in 523 patients (1046 eyes), using the Ocular Surface Disease Index (OSDI) and Brief Ocular Discomfort Index (BODI) during 2 visits spaced approximately 2 weeks apart. To evaluate DED signs, a single physician conducted tests in a consistent sequence, including tear break-up time (TBUT), corneal and conjunctival staining, Meibomian gland evaluation, and the Schirmer test for tear production. The reliability of these measures was analyzed using interclass correlation coefficient, limits of agreement, and clinically significant change thresholds.

Interclass correlation coefficient values for DED signs ranged from moderate (0.53 for TBUT) to relatively strong (0.73 for corneal staining). Clinically meaningful differences between visits were observed in a substantial portion of eyes, particularly for Schirmer test results (29.9%) and Meibomian gland assessments (27.5%). Symptom scores also fluctuated, with nearly 40% of patients experiencing significant changes between visits on both the OSDI and BODI measures.

Reference
Chen A, Augello P, Asbell P, et al; DREAM Research Group. The repeatability of tests for dry eye signs and symptoms in the dry eye assessment and management (DREAM) study. Cont Lens Anterior Eye. 2024;102322. doi: 10.1016/j.clae.2024.102322. Epub ahead of print. PMID: 39477774.