Korean Guidelines for the Diagnosis and Management of Dry Eye: Development and Validation of Clinical Efficacy

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate the clinical efficacy of newly developed guidelines for the diagnosis and management ofdry eye.
Methods: This retrospective, multi-center, non-randomized, observational study included a total of 1,612 patientswith dry eye disease who initially visited the clinics from March 2010 to August 2010. Korean guidelinesfor the diagnosis and management of dry eye were newly developed from concise, expert-consensus recommendations.
Severity levels at initial and final visits were determined using the guidelines in patients with 90± 7 days of follow-up visits (n = 526). Groups with different clinical outcomes were compared with respect toclinical parameters, treatment modalities, and guideline compliance. Main outcome measures were ocular andvisual symptoms, ocular surface disease index, global assessment by patient and physician, tear film break-uptime, Schirmer-1 test score, ocular surface staining score at initial and final visits, clinical outcome after threemonths of treatment, and guideline compliance.
Results: Severity level was reduced in 47.37% of patients treated as recommended by the guidelines. Youngerage (odd ratio [OR], 0.984; p = 0.044), higher severity level at initial visit, compliance to treatment recommendation(OR, 1.832; p = 0.047), and use of topical cyclosporine (OR, 1.838; p = 0.011) were significantly associatedwith improved clinical outcomes.
Conclusions: Korean guidelines for the diagnosis and management of dry eye can be used as a valid and effectivetool for the treatment of dry eye disease.

참고문헌 (Reference)

1 Sall K, "Two multicenter, randomized studies of the efficacy and safety of cyclosporine ophthalmic emulsion in moderate to severe dry eye disease. CsA Phase 3 Study Group" 107 : 631-639, 2000

2 Nichols KK, "The lack of association between signs and symptoms in patients with dry eye disease" 23 : 762-770, 2004

3 Nelson JD, "The international workshop on meibomian gland dysfunction:report of the definition and classification subcommittee" 52 : 1930-1937, 2011

4 "The epidemiology of dry eye disease: report of the Epidemiology Subcommittee of the International Dry Eye Work-Shop (2007)" 5 : 93-107, 2007

5 "The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007)" 5 : 75-92, 2007

6 Lemp MA, "Report of the National Eye Institute/Industry workshop on clinical trials in dry eyes" 21 : 221-232, 1995

7 Schiffman RM, "Reliability and validity of the Ocular Surface Disease Index" 118 : 615-621, 2000

8 Han SB, "Prevalence of dry eye disease in an elderly Korean population" 129 : 633-638, 2011

9 Barber LD, "Phase III safety evaluation of cyclosporine 0.1% ophthalmic emulsion administered twice daily to dry eye disease patients for up to 3 years" 112 : 1790-1794, 2005

10 "Methodologies to diagnose and monitor dry eye disease:report of the Diagnostic Methodology Subcommittee of the International Dry Eye WorkShop (2007)" 5 : 108-152, 2007

11 "Management and therapy of dry eye disease: report of the Management and Therapy Subcommittee of the International Dry Eye WorkShop (2007)" 5 : 163-178, 2007

12 Bron AJ, "Grading of corneal and conjunctival staining in the context of other dry eye tests" 22 : 640-650, 2003

13 Perry HD, "Evaluation of topical cyclosporine for the treatment of dry eye disease" 126 : 1046-1050, 2008

14 Behrens A, "Dysfunctional tear syndrome:a Delphi approach to treatment recommendations" 25 : 900-907, 2006

15 Nichols KK, "Association of clinical diagnostic tests and dry eye surveys: the NEI-VFQ-25 and the OSDI" 506 (506): 1177-1181, 2002

16 Wilson SE, "Agreement of physician treatment practices with the international task force guidelines for diagnosis and treatment of dry eye disease" 26 : 284-289, 2007

17 Baiza-Duran L, "A comparative clinical trial of the efficacy of two different aqueous solutions of cyclosporine for the treatment of moderate-to-severe dry eye syndrome" 94 : 1312-1315, 2010