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AI InsightTARTIŞMA: Kuru göz olgularında semptomlar ve klinik bulgular değişkendir.
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Özet
AMAÇ: Kuru gözde kullanılan oküler yüzey hastalığısemptomlarıindeksi(OYHİ) ile Delphi paneli sınıflandırması ve tanı yöntemlerinin uyumunu değerlendirmek GEREÇ ve YÖNTEM: Çalışmaya 6sı primer Sjögren, 6si sekonder Sjögren kuru göz, 42si non-Sjögren kuru göz tanısı alan toplam 54 hasta dahil edildi. Olgulara göz yaşı kırılma zamanı testi, anestezili ve anestezisiz Schirmer testi yapıldı. Lissamin yeşili boyası ile oküler yüzey boyanması (0-4), fluoresein boyası ile korneal boyanma (0-3) skorlandı. Biyomikroskopik muayenede meibomian bez disfonksiyonu (MBD) değerlendirildi (0- 3). Kuru göz semptomlarının araştırılması için oküler yüzey hastalık indeksi (OYHİ) anketi uygulandı. Kuru göz Delphi paneli sınıflandırmasına göre derecelendirildi (1- 4). OYHİ ile tanı test sonuçları ve kuru göz ağırlık derecesi arasındaki ilişki araştırıldı. İstatistikseldeğerlendirmedeKi-kare bağımsızlık testi kullanıldı. p < 0.05 anlamlı olarak kabul edildi. SONUÇLAR: Olguların 47si kadın, 7si erkek ve yaş ortalaması 52.1±9.7 (33-79) yaş idi. OYHİ skoru ile kornea fluoresein boyanması (p= 0.006) ve kuru göz Delphi paneli sınıflandırması (p= 0.003) arasındaki ilişki istatistiksel olarak anlamlı bulundu. OYHİ ile göz yaşı kırılma zamanı testi, anestezili ve anestezisiz Schirmer testi, meibomian bez disfonksiyonu ve Lissamin yeşili boyasıyla oküler yüzey boyanma skoru istatistiksel olarak uyumlu bulunmadı. TARTIŞMA: Kuru göz olgularında semptomlar ve klinik bulgular değişkendir. Olguların pek çoğunda hastanın semptomları tanı testleri ve bulgularla uyum göstermemektedir. Bu çalışmada kuru gözde semptomları sorgulayan anket olarak kullanılan OYHİ ile Delphi paneli sınıflandırması ve kornea fluoresein boyanması uyumlu bulunmuştur.
Abstract
INDEX (OSDI) IN DRY EYE DİSEASE PURPOSE: To evaluate correlation between diagnosis test results, delphi panel classification of dry eye disease (DED) and ocular surface disease index (OSDI). MATERİALS and METHODS: 54 subjects who had dry eye diagnosis were admitted to the study. At ocular examination tear breakup time (TBUT) test, Schirmer s test with and without topical anesthesia were applied. At slit-lamp examination meibomian gland disfunction, ocular surface staining with lissamine green and corneal staining with fluorescein were scored. Dry eye severity was graded based on Delphi panel classification. OSDI questionnaire was performed to all patients. The correlation between diagnosis test results, dry eye severity and OSDI scores were observed. Statistical analyses used Chi-square test, p ≤ 0.05 was considered statistically significant. RESULTS: The mean age of our subjects was 52.1 ± 9.7 years (range 33-79 years), including 47 women and 7 men. Within this group, there were 6 primary Sjögren, 6 secondary Sjögren and 42 non-Sjögren patients. The correlation between corneal staining with fluorescein score (p=0.006), dry eye severity estimated by Delphi panel classification (p=0.003) and OYHI score was statistically significant. There was no statistically significant correlation between TBUT test, Schirmer s test with and without topical anesthesia, MGD, ocular surface staining with lissamine green and OSDI score. CONCLUSİONS: DED is a multifactorial disorder of the tear film and ocular surface that results in eye discomfort, visual disturbance, and possible ocular surface damage. Currently there are no uniform diagnostic criteria. DED is considered a symptomatic disease; assessment of symptoms is considered of primary importance, and may be aided by use of validated symptom questionnare. Combination of various tests have been used to evaluate clinical signs, but although diagnostic tests are useful for confirming the diagnosis they often correlate poorly with symptoms. with and without topical anesthesia were applied. At slit-lamp examination meibomian gland disfunction, ocular surface staining with lissamine green and corneal staining with fluorescein were scored. Dry eye severity was graded based on Delphi panel classification. OSDI questionnaire was performed to all patients. The correlation between diagnosis test results, dry eye severity and OSDI scores were observed. Statistical analyses used Chi-square test, p ≤ 0.05 was considered statistically significant. RESULTS: The mean age of our subjects was 52.1 ± 9.7 years (range 33-79 years), including 47 women and 7 men. Within this group, there were 6 primary Sjögren, 6 secondary Sjögren and 42 non-Sjögren patients. The correlation between corneal staining with fluorescein score (p=0.006), dry eye severity estimated by Delphi panel classification (p=0.003) and OYHI score was statistically significant. There was no statistically significant correlation between TBUT test, Schirmer s test with and without topical anesthesia, MGD, ocular surface staining with lissamine green and OSDI score. CONCLUSİONS: DED is a multifactorial disorder of the tear film and ocular surface that results in eye discomfort, visual disturbance, and possible ocular surface damage. Currently there are no uniform diagnostic criteria. DED is considered a symptomatic disease; assessment of symptoms is considered of primary importance, and may be aided by use of validated symptom questionnare. Combination of various tests have been used to evaluate clinical signs, but although diagnostic tests are useful for confirming the diagnosis they often correlate poorly with symptoms.