Abstract:Introduction and Background: Instabilities in the tear film, which can cause pain and even vision loss, characterise DED, a common ocular condition. However, there are obstacles to achieving an accurate diagnosis, which is crucial for efficient treatment, due to the fact that diagnostic test performance varies. The purpose of this research is to examine and contrast the diagnostic accuracy of several hospital-based DED tests.
Materials and Methods: The study had 150 patients in all, with an average age of 45.6 ± 12.3 years. This study was conducted at the department of Ophthalmology, Kamineni Institute of Medical Sciences, Nalgonda, Telangana, India from March 2015 to February 2016. Patients experiencing signs of DED were the subjects of a comparative investigation that took place in a hospital setting. The participants were subjected to a thorough eye exam that included standard diagnostic procedures like Schirmer's test, TBUT, OSS, and tear osmolarity.
Results: Out of 150 individuals, 108 (72% of the total) had clinically verified instances of DED. There was a good association between clinical diagnosis and Tear Osmolarity, the most sensitive and specific diagnostic test (κ = 0.82) among those that were considered. With a moderate agreement (κ = 0.71), TBUT demonstrated a sensitivity of 81.2% and specificity of 75.5%. The sensitivity and specificity of Ocular Surface Staining (OSS) were 77.8% and 71.2%, respectively, and the agreement was fair (κ = 0.68). The accuracy was lowest with Schirmer's Test, which showed reasonable agreement (κ = 0.63), and had a sensitivity of 72.6% and specificity of 69.1%. The significance of a multi-test method was further highlighted by the fact that diagnostic accuracy was much enhanced (κ = 0.88) when all tests were used together.
Conclusion: Although TBUT and Schirmer's test were helpful in diagnosing DED, tear osmolarity was the most accurate test used alone. The accuracy of diagnosing DED was improved by combining different diagnostic tests. In order to enhance patient outcomes, our data highlight the necessity of a standardised diagnostic strategy.