OSDI Questions on Daily Life Activities Allow to Detect Subclinical Dry Eye in Young Contact Lens Users

Abstract

Dry eye disease (DED) is difficult to detect in young contact lens (CL) wearers, who usually have no signs, mild symptoms and an ocular surface disease index (OSDI) below the DED diagnosis values (OSDI ≥ 13). We investigate if some of the 12 OSDI questions (OSDI A—ocular symptoms; OSDI B—vision-related functionality; OSDI C—environmental triggers) contribute the most to classify young CL as symptomatic. TBUT and tear volume are also measured. Age, gender and refraction error-matched eye glasses (EG) wearers participated as the control. CL and EG data were compared with t-test and z-test. Confusion matrices and logistic correlation analyses were performed to define the contribution of each OSDI question to classify symptomatic subjects. OSDI classified symptomatic CL better than the tear volume or TBUT values. In CL, only OSDI B and C values were significantly higher in symptomatic vs. asymptomatic subjects (p < 0.001), while values of all twelve OSDI questions were significantly higher in symptomatic vs. asymptomatic EG (p < 0.05−0.001). All OSDI questions contribute equally to identify symptomatic EG, while only OSDI B questions on daily life visual functions are significant to classify symptomatic CL wearers at risk to develop DED or at a subclinical stage. CL wearers scoring ≥ 2 on the OSDI B questions should be considered for preventive treatments, even if their clinical sings are scarce or absent.

Keywords: OSDI; contact lens; daily life activities; dry eye disease symptoms; ocular symptoms evaluation.

Figure 1

Logistic regression coefficients calculated for the twelve OSDI questions in young eyeglasses (EG) (A) and contact lens (CL) (B) wearers. In the EG group, the values given to all the questions contributed significantly (p < 0.001, t- test of conformity). In the CL group, only the score given to “reading” was nearly significant (p = 0.05, t-test of conformity).

Figure 2

Confusion matrix for the classification of young eyeglasses (EG) (A) and contact lens (CL) (B) wearers as asymptomatic or symptomatic using OSDI D scores (true label) and logistic regression prediction (predicted label). The number of subjects was shown inside each box.

Figure 3

Confusion matrix for the classification of young eyeglasses (EG) (A) and contact lens (CL) (B) wearers as asymptomatic or symptomatic using OSDI D scores and the presence of clinical signs (reduced tear rate and/or TBUT). The number of subjects was shown inside each box.