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dc.contributor.authorYazdani, Mazyar
dc.contributor.authorChen, Xiangjun
dc.contributor.authorTashbayev, Behzod
dc.contributor.authorUtheim, Øygunn Aass
dc.contributor.authorRæder, Sten
dc.contributor.authorLagli, Neil
dc.contributor.authorStojanovic, Aleksandar
dc.contributor.authorDartt, Darlene Ann
dc.contributor.authorUtheim, Tor Paaske
dc.date.accessioned2019-02-28T09:56:34Z
dc.date.available2019-02-28T09:56:34Z
dc.date.created2018-10-05T19:27:18Z
dc.date.issued2018
dc.identifier.citationCurrent Eye Research. 2018, 43(12), 1-7.nb_NO
dc.identifier.issn0271-3683
dc.identifier.urihttp://hdl.handle.net/11250/2587975
dc.description.abstractPurpose: To determine if the Schirmer I test (without anesthesia) cut-off value is a predictor of dry eye severity in a large Norwegian cohort of dry eye disease (DED) patients, which are grouped into six levels of tear production. Methods: Patients (n = 1090) with DED of different etiologies received an extensive dry eye work-up: osmolarity (Osm), tear meniscus height (TMH), tear film break-up time (TFBUT), ocular protection index (OPI), ocular surface staining (OSS), Schirmer I test (ST), meibum expressibility (ME), and meibum quality (MQ). Classification of dry eye severity level (DESL) and diagnosis of meibomian gland dysfunction (MGD) were also included. The cohort was divided into six groups: below and above cut-off values of 5 (groups 1 and 2), 10 (groups 3 and 4), and 15 mm (groups 5 and 6) of ST. Mann-Whitney test and Chi-Square test were used for group comparison of parameters (p ≤ 0.05). Results: The groups 1, 3, and 5 had values indicating more severe DED than the groups 2, 4, 6 with significant difference in DESL, Osm, TFBUT, OPI, OSS, and TMH. Regardless of the choice of cut-off values, there was no statistically significant difference in ME, MQ, and MGD between groups below and above selected cut-off value. When gender difference was considered in each group, significant difference was only observed for DESL (groups 2, 4, and 5), TFBUT (groups 2, 4, and 5), OPI (groups 2 and 6), and ME (group1). Conclusions: Schirmer I is a robust discriminator for DESL, Osm, TFBUT, OPI, OSS, and TMH, but not for ME, MQ, and MGD. Patients with lower tear production levels presented with more severe DED at all three defined cut-off values. Interestingly, the differences in the mean values of DESL were minimal although statistically significant. Thus, the clinical value of different Schirmer levels appears to be limited. KEYWORDS: Dry eye disease, Schirmer I test, tear production levels, clinical tests, large population of patientsnb_NO
dc.language.isoengnb_NO
dc.titleTear production levels and dry eye disease severity in a large Norwegian cohortnb_NO
dc.title.alternativeTear production levels and dry eye disease severity in a large Norwegian cohortnb_NO
dc.typeJournal articlenb_NO
dc.typePeer reviewednb_NO
dc.description.versionacceptedVersionnb_NO
dc.rights.holderTaylor & Francisnb_NO
dc.source.pagenumber1-7nb_NO
dc.source.volume43nb_NO
dc.source.journalCurrent Eye Researchnb_NO
dc.source.issue12nb_NO
dc.identifier.doi10.1080/02713683.2018.1514055
dc.identifier.cristin1618283
cristin.unitcode222,56,2,0
cristin.unitnameInstitutt for optometri, radiografi og lysdesign
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode1


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