Evaluation of the Ocular Surface Disease Index Questionnaire as a Discriminative Test for Clinical Findings in Dry Eye Disease Patients

Figures & data

Figure 1. Subjects demographics: Bar graph showing the age and gender distribution among 1090 subjects tested for dry eye disease.

Table 1. Summary of ROC curve parameters and distribution of clinical tests.

Variables	AUC*	P value	Cut-off value	Sensitivity (%)	Specificity (%)	Mean ± SE	Min. – Max.
Osmolarity > 308**	0.514 ± 0.028	0.632	35.9	48	52	317.05 ± 0.796	276–398
Osmolarity > 316**	0.492 ± 0.026	0.769	35.2	49	47	317.05 ± 0.796	276–398
TFBUT ≤ 5	0.553 ± 0.021	0.012	30.3	57	47	4.30 ± 0.112	0–20
TFBUT ≤ 10	0.608 ± 0.034	0.002	22.8	69	38	4.30 ± 0.112	0–20
OPI	0.497 ± 0.018	0.880	27.2	60	40	1.757 ± 0.054	0–20
OSS > 1	0.528 ± 0.018	0.128	32.9	53	47	1.88 ± 0.068	0–13
OSS ≥ 3	0.54 ± 0.021	0.043	22.9	68	34	1.88 ± 0.068	0–13
ST ≤ 5	0.550 ± 0.024	0.032	35.7	53	54	14.67 ± 0.308	0–36
ST ≤ 10	0.544 ± 0.018	0.016	35.2	52	51	14.67 ± 0.308	0–36
ME	0.594 ± 0.021	<0.001	31.5	56	52	1.45 ± 0.029	0–3
MQ	0.523 ± 0.032	0.477	35.2	50	52	8.12 ± 0.156	0–24
MGD	0.568 ± 0.053	0.193	35.2	51	56	- ***	0–1

* AUC: Area under the curve.

** Osmolarity was only assessed in 520 subjects in comparison with other clinical tests (n = 1090).

*** MGD is dichotomous (0 and 1), and there is no mean ± standard error.

- Abbreviations: tear film break-up time (TFBUT), ocular protection index (OPI), ocular surface staining (OSS, Oxford Grading Scheme), Schirmer I test (ST), meibum expressibility (ME), meibum quality (MQ), meibomian gland disease (MGD).

- Pathological DED was defined as osmolarity >308 and >316 mOsm/L, TMH ≤ 0.1 mm, TFBUT ≤5 and ≤10 seconds, OPI < 1, OSS >1 and ≥3, ST ≤5 and ≤10 mm in 5 min, ME ≥ 1, MQ > 1 and MGD > 0.

Figure 2. ROC curve is displayed to determine the optimum balanced sensitivity and specificity of OSDI to predict pathological osmolarity, TFBUT, OPI, ST, OSS, ME, MQ and MGD. Abbreviations: tear film break-up time (TFBUT), ocular protection index (OPI), Schirmer I test (ST), ocular surface staining (OSS, Oxford Grading Scheme), meibum expressibility (ME), meibum quality (MQ), meibomian gland disease (MGD).