Study identifies key factors behind symptom-sign discrepancy in dry eye disease

Dry eye disease (DED) can present with a significant mismatch between symptoms and clinical signs, particularly in patients of Asian descent and those using immunomodulating medications, according to a study. This suggests that even in the absence of severe symptoms, such individuals may exhibit serious ocular signs, warranting regular eye evaluations.

This cross-sectional study analyzed data from 3,455 participants in the Sjögren’s International Collaborative Clinical Alliance, in order to identify factors influencing this discrepancy and develop predictive models to better understand it.

Researchers used a multivariable regression model to analyze differences between the Ocular Surface Disease Index (OSDI-6) scores and ocular staining scores (OSS). Ten key predictors emerged, including vitality, use of immunomodulating drugs, sensory symptoms, and ethnicity. The final model explained 35% of the variability in symptom-sign discordance, with medication use accounting for 19% and medical history contributing 18%. Health-related quality of life and demographic factors also played notable roles.

The study’s findings suggest that certain groups, particularly individuals of Asian descent and those on immunomodulating medications, are more likely to exhibit severe ocular signs even if their symptoms do not correspond. In addition, patients reporting abnormal sensations elsewhere in the body alongside ocular symptoms may require further investigation for underlying systemic conditions.

Reference
Xiong F, Arnold BF, Lietman TM, et al. Predictors of Discordance Between Dry Eye Symptoms and Signs: Insights From the Sjögren’s International Collaborative Clinical Alliance. Invest Ophthalmol Vis Sci. 2024;65(12):3. doi: 10.1167/iovs.65.12.3. PMID: 39365264.