Editorial
La retina como marcador biológico de daño neuronal
Artículos originales
Comparación de tres instrumentos de tomografía de
coherencia óptica, un time-domainy dos Fourier-
domain, en la estimación del grosor de la capa de
fibras nerviosas de la retina
Idoneidad de tratamiento en sospechosos de glauco-
ma. Estudio de concordancia con el grupo de estu-
dio RAND
Atrofia de la capa de fibras nerviosas de la retina en
pacientes con esclerosis múltiple. Estudio prospec-
tivo con dos años de seguimiento
Comunicaciones cortas
Hipercorrección secundaria a transposición muscular
aumentada
Crítica de libros, medios audiovisuales y páginas
web oftalmológicos
Clinical Neuro-Ophthalmology: The Essentials
Sección histórica
Del mal de la rosa y la queratoconjuntivitis pelagrosa
Sección iconográfica
El estrabismo de Rembrandt
Sociedades y Reuniones Científicas
Ofertas de trabajo
Vol. 85 Mayo 2010 Núm. 5
Contenido
ARCHIVOS
DE LA SOCIEDAD
ESPAÑOLA
DE OFTALMOLOGÍA
Indexada en:
PubMed/MEDLINE, Scopus, EMBASE/
Excerpta Medica, IBECS, IME, SCIELO,
BIOSIS, SENIOR y COMPLUDOC
www.oftalmo.com/seo
www.elsevier.es/oftalmologia
ARCHIVOS DE LA SOCIEDAD
ESPAÑOLA DE OFTALMOLOGÍA
www.elsevier.es/oftalmologia
ARCH SOC ESP OFTALMOL. 2011;86(1):3–7
0365-6691/$ - see front matter © 2009 Sociedad Española de Oftalmología. Published by Elsevier España, S.L. All rights reserved.
Original article
Lack of concordance between dry eye syndrome
questionnaires and diagnostic tests
G. Fuentes-Páez,
a
J.M. Herreras,
b,
* Y. Cordero,
b
A. Almaraz,
b
M.J. González,
b
M. Calonge
b
a
Asociación Para Evitar La Ceguera en México, México City, Mexico
b
Universidad de Valladolid, Spain
ARTICLE INFORMATION
Article history:
Received on May 30, 2009
Accepted on June 18, 2010
Keywords:
McMonnies questionnaire
OSDI questionnaire
Keratoconjunctivitis sicca
Dry eye syndrome
*Corresponding author. Grupo de Superficie Ocular; IOBA, Universidad de Valladolid, Spain.
E-mail: herreras@ioba.med.uva.es (J.M. Herreras)..
ABSTRACT
Purpose: To report the prevalence of dry eye syndrome (DES) in a subset of patients
>50 years old in Valladolid, Spain, calculate internal validity of two DES screening
questionnaires, and correlate the results with DES diagnostic tests.
Methods: Patients >50 years-old were randomly selected from the medical network census
in Valladolid; they answered the modified McMonnies questionnaire (Q1) and the Ocular
Surface Index questionnaire (Q2) and then underwent an ophthalmic evaluation which
included: tear break-up time (TBUT), fluorescein and Rose Bengal staining, and Schirmer
with anesthesia were performed. Descriptive analysis, test concordance analysis, and Q1
and Q2 reliability using ROC curves were performed.
Results: A total of 270 subjects (58.2% female; 41.8% male) with an average age of 64.5 years
(95% CI: 63.3-65.7) were enrolled. The prevalence of DES based on the Schirmer-Tear break-
up time tests combination was 24.2%. The mean Q1 score was 1.2, and 1.4 for Q2. Grittiness
and discomfort in dry environments (28.9%) were the most common symptoms recorded
for Q1. For Q2 “grittiness” (99.2%) and “burning sensation” (98.9%)were the most common
symptoms. With the Schirmer-TBUT combination, DES prevalence in Valladolid was 24.2%,
45.8% with TBUT, and 45.6% with Schirmer test. Values for the areas under the ROC curve
for Q1, Q2, and most objective tests were < 0.5, except for Q2 and TBUT (0.503). Cronbach
alpha was >0.7 for all Q1 and Q2 items. Statistically significant concordance was reported
for Schirmer - TBUT (k=0.14) and TBUT- fluorescein staining (k=0.09); (P<0.05).
Conclusions: Q1 and Q2 were unreliable for DES diagnosis and showed poor internal
consistency. Fluorescein and Rose Bengal staining were the most concordant tests for DES
diagnosis. Finally, there was no correlation between either screening questionnaire and
objective DES diagnostic tests.
© 2009 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.
All rights reserved.