Study investigates intereye agreement in dry eye disease signs

Although there is generally moderate-to-good agreement between the eyes in dry eye disease (DED) signs, a significant proportion of patients exhibit clinically important differences between their eyes, according to a study.

The research, conducted as part of the Dry Eye Assessment and Management study, evaluated various diagnostic metrics at baseline, 3, 6, and 12 months.

The study employed intraclass correlation coefficients, weighted kappa statistics, and percentage of participants with absolute intereye differences (AID) exceeding clinically significant thresholds to assess agreement. Results indicated moderate-to-good intereye agreement across different DED signs. Specifically, intraclass correlation coefficients ranged from 0.45 for tear osmolarity to 0.81 for corneal staining and the Schirmer test. Weighted kappa values ranged from 0.58 for plugging to 0.69 for lid secretion.

However, the study also found a notable percentage of participants exhibiting clinically significant intereye differences. AID percentages ranged from 15% to 47% across different metrics, with tear osmolarity showing the highest discrepancy at 44% to 47%. In addition, the eye with worse DED signs varied from 36% of participants for TBUT to 80% for osmolarity.

The researchers concluded that this variability underscores the importance of evaluating both eyes in future DED clinical trials.

Reference
Zhong A, Augello P, Asbell P, et al; DREAM Study Research Group. Intereye Agreement in Dry-Eye Signs in the DREAM Study: Implications for Future Dry-Eye Trials. Cornea. 2024;doi: 10.1097/ICO.0000000000003605. Epub ahead of print. PMID: 39079754.