Symptom-based stratification algorithm for heterogeneous symptoms of dry eye disease: a feasibility study.


Journal

Eye (London, England)
ISSN: 1476-5454
Titre abrégé: Eye (Lond)
Pays: England
ID NLM: 8703986

Informations de publication

Date de publication:
Nov 2023
Historique:
received: 10 01 2023
accepted: 06 04 2023
revised: 31 03 2023
pmc-release: 01 11 2024
medline: 9 11 2023
pubmed: 16 4 2023
entrez: 15 4 2023
Statut: ppublish

Résumé

To test the feasibility of a dry eye disease (DED) symptom stratification algorithm previously established for the general population among patients visiting ophthalmologists. This retrospective cross-sectional study was conducted between December 2015 and October 2021 at a university hospital in Japan; participants who underwent a comprehensive DED examination and completed the Japanese version of the Ocular Surface Disease Index (J-OSDI) were included. Patients diagnosed with DED were stratified into seven clusters using a previously established symptom-based stratification algorithm for DED. Characteristics of the patients in stratified clusters were compared. In total, 426 participants were included (median age [interquartile range]; 63 [48-72] years; 357 (83.8%) women). Among them, 291 (68.3%) participants were diagnosed with DED and successfully stratified into seven clusters. The J-OSDI total score was highest in cluster 1 (61.4 [52.2-75.0]), followed by cluster 5 (44.1 [38.8-47.9]). The tear film breakup time was the shortest in cluster 1 (1.5 [1.1-2.1]), followed by cluster 3 (1.6 [1.0-2.5]). The J-OSDI total scores from the stratified clusters in this study and those from the clusters identified in the previous study showed a significant correlation (r = 0.991, P < 0.001). The patients with DED who visited ophthalmologists were successfully stratified by the previously established algorithm for the general population, uncovering patterns for their seemingly heterogeneous and variable clinical characteristics of DED. The results have important implications for promoting treatment interventions tailored to individual patients and implementing smartphone-based clinical data collection in the future.

Sections du résumé

BACKGROUND/OBJECTIVE OBJECTIVE
To test the feasibility of a dry eye disease (DED) symptom stratification algorithm previously established for the general population among patients visiting ophthalmologists.
SUBJECT/METHODS METHODS
This retrospective cross-sectional study was conducted between December 2015 and October 2021 at a university hospital in Japan; participants who underwent a comprehensive DED examination and completed the Japanese version of the Ocular Surface Disease Index (J-OSDI) were included. Patients diagnosed with DED were stratified into seven clusters using a previously established symptom-based stratification algorithm for DED. Characteristics of the patients in stratified clusters were compared.
RESULTS RESULTS
In total, 426 participants were included (median age [interquartile range]; 63 [48-72] years; 357 (83.8%) women). Among them, 291 (68.3%) participants were diagnosed with DED and successfully stratified into seven clusters. The J-OSDI total score was highest in cluster 1 (61.4 [52.2-75.0]), followed by cluster 5 (44.1 [38.8-47.9]). The tear film breakup time was the shortest in cluster 1 (1.5 [1.1-2.1]), followed by cluster 3 (1.6 [1.0-2.5]). The J-OSDI total scores from the stratified clusters in this study and those from the clusters identified in the previous study showed a significant correlation (r = 0.991, P < 0.001).
CONCLUSIONS CONCLUSIONS
The patients with DED who visited ophthalmologists were successfully stratified by the previously established algorithm for the general population, uncovering patterns for their seemingly heterogeneous and variable clinical characteristics of DED. The results have important implications for promoting treatment interventions tailored to individual patients and implementing smartphone-based clinical data collection in the future.

Identifiants

pubmed: 37061620
doi: 10.1038/s41433-023-02538-4
pii: 10.1038/s41433-023-02538-4
pmc: PMC10630441
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3484-3491

Subventions

Organisme : MEXT | Japan Society for the Promotion of Science (JSPS)
ID : 20KK0207
Organisme : MEXT | Japan Society for the Promotion of Science (JSPS)
ID : 21K17311
Organisme : MEXT | Japan Society for the Promotion of Science (JSPS)
ID : 21K20998

Informations de copyright

© 2023. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.

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Auteurs

Ken Nagino (K)

Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Takenori Inomata (T)

Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan. tinoma@juntendo.ac.jp.
Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan. tinoma@juntendo.ac.jp.
Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. tinoma@juntendo.ac.jp.
Juntendo University Graduate School of Medicine, AI Incubation Farm, Tokyo, Japan. tinoma@juntendo.ac.jp.

Masahiro Nakamura (M)

Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Precision Health, Department of Engineering, Graduate School of Bioengineering, The University of Tokyo, Tokyo, Japan.

Jaemyoung Sung (J)

Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
University of South Florida, Morsani College of Medicine, Tampa, FL, USA.

Akie Midorikawa-Inomata (A)

Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Masao Iwagami (M)

Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.

Kenta Fujio (K)

Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Yasutsugu Akasaki (Y)

Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Yuichi Okumura (Y)

Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Tianxiang Huang (T)

Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Keiichi Fujimoto (K)

Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Atsuko Eguchi (A)

Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Maria Miura (M)

Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Shokirova Hurramhon (S)

Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Jun Zhu (J)

Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Mizu Ohno (M)

Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Kunihiko Hirosawa (K)

Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Yuki Morooka (Y)

Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Reza Dana (R)

Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.

Akira Murakami (A)

Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Hiroyuki Kobayashi (H)

Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan.

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