RESUMO
Dry eye disease (DED) has a higher prevalence than many important systemic disorders like cardiovascular disease and diabetes mellitus, representing a significant quality of life burden for the affected patients. It is a common reason for consultation in general eye clinics worldwide. Nowadays, the diagnostic and therapeutic approach at the high corneal and ocular surface specialty level should be reserved for cases of severe and chronic dry eye disease associated with systemic autoimmune diseases or complicated corneal and ocular surface pathologies. In such cases, the diagnostic and therapeutic approach is often complex, elaborate, time-consuming, and costly due to the use of extensive dry eye questionnaires, noninvasive electronic diagnostic equipment, and clinical laboratory and ancillary tests. However, other eye care specialists attend a fair amount of DED cases; therefore, its diagnosis, classification, and management should be simple, practical, achievable, and effective. Considering that many patients attending non-specialized dry eye clinics would benefit from better ophthalmological attention, we decided to elaborate a practical DED classification system based on disease severity to help clinicians discriminate cases needing referral to subspecialty clinics from those they could attend. Additionally, we propose a systematic management approach and general management considerations to improve patients' therapeutic outcomes according to disease severity.
RESUMO
PURPOSE: To translate and validate a Spanish-language adaptation of the 5-Item Dry Eye Questionnaire for the Mexican population. METHODS: Based on the MAPI Institute guidelines, the linguistic validation procedures consisted of four steps. Every step was reviewed by the committee. The translated validated questionnaire was applied to 25 Mexican subjects. The questionnaires were completed by the same subjects at three time points, 8 h apart on the same day and then 3 days later. Sensitivity and specificity of the DEQ-5 to predict DE signs was subsequently estimated in 200 patients see in the Asociación para Evitar la Ceguera ophthalmology clinic. RESULTS: During the forward translation step analysis, the committee decided to change the severity scale, as the words "constantly" and "frequently" are synonymous in Spanish, so it was modified by changing "constantly" to "always" for better understanding. Overall, the intra-test intra-class correlation coefficient from tests administered on the same day was 0.9 (95% CI 0.77-0.95, p = 0.0005). The intra-test intra-class correlation coefficient from tests administered 3 days apart was 0.9 (95% CI 0.88-0.97, p = 0.0005). When applying the questionnaire to 200 patients seen in an eye clinic, we found a sensitivity of 76% and a specificity of 31% for a DEQ-5 score of ≥ 6, against 2 or more positive signs of dry eye. CONCLUSION: MAPI methodology proved to be a reliable strategy for the transcultural Dry Eye Questionnaire for translation from English to Spanish for the Mexican population.
Assuntos
Comparação Transcultural , Síndromes do Olho Seco/diagnóstico , Psicometria/instrumentação , Inquéritos e Questionários/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Técnicas de Diagnóstico Oftalmológico/estatística & dados numéricos , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Traduções , Adulto JovemRESUMO
OBJECTIVE: To determine the prevalence of dry eye symptoms (DES) and associated risk factors among adults in Tlaxcala, Mexico. MATERIALS AND METHODS: A cross-sectional population-based study that included 1 508 individuals aged ≥50 years who answered the Dry Eye Questionnaire (DEQ5), with a score ranging between 0 and 22; the following categories were defined: no DES (<6); mild-moderate DES (6 to 11) and severe DES (≥12). RESULTS: The prevalence of DES was 41.1% (95%CI 38.6-43.6), and was higher in women (OR=2.26, 95%IC 1.70-3.00), in individuals with smoking index of <10 (OR=1.40, 95%CI 1.05-1.87) and ≥10 pack-years (OR=2.29, 95%CI 1.44-3.63), compared to never-smokers, subjects with history of ever consuming alcohol (OR=1.31, 95%CI 1.02-1.70), and those receiving antihypertensive treatment (OR=1.29, 95%CI 1.00-1.65). CONCLUSIONS: Dry eye symptoms were highly prevalent in the study population and were associated with sex, smoking, alcohol consumption, and antihypertensive medications.
Assuntos
Síndromes do Olho Seco/diagnóstico , Idoso , Estudos Transversais , Síndromes do Olho Seco/epidemiologia , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Avaliação de SintomasRESUMO
Abstract: Objective: To determine the prevalence of dry eye symptoms (DES) and associated risk factors among adults in Tlaxcala, Mexico. Materials and methods: A cross-sectional population-based study that included 1 508 individuals aged ≥50 years who answered the Dry Eye Questionnaire (DEQ-5), with a score ranging between 0 and 22; the following categories were defined: no DES (<6); mild-moderate DES (6 to 11) and severe DES (≥12). Results: The prevalence of DES was 41.1% (95%CI 38.6-43.6), and was higher in women (OR=2.26, 95%IC 1.70-3.00), in individuals with smoking index of <10 (OR=1.40, 95%CI 1.05-1.87) and ≥10 pack-years (OR=2.29, 95%CI 1.44-3.63), subjects with history of ever consuming alcohol (OR=1.31, 95%CI 1.02-1.70), and those receiving antihypertensive treatment (OR=1.29, 95%CI 1.00-1.65). Conclusion: Dry eye symptoms were highly prevalent in the study population and were associated with sex, smoking, alcohol consumption, and antihypertensive medications.
Resumen: Objetivo: Determinar la prevalencia de síntomas de ojo seco y factores de riesgo asociados en población adulta de Tlaxcala, México. Material y métodos: Se realizó un estudio de base poblacional con 1 508 individuos ≥50 años que respondieron el Dry Eye Questionnaire (DEQ-5) y se definieron las siguientes categorías: sin síntomas (<6); síntomas leve-moderado (6 a11) y síntomas severos (≥12). Resultados: La prevalencia de síntomas de ojo seco fue de 41.1% (IC95% 38.6-43.6); fue mayor en mujeres (OR=2.26, IC95% 1.70-3.00), en individuos con índice de tabaquismo <10 (OR=1.40, IC95% 1.05-1.87) y ≥10 paquetes-año (OR=2.29, IC95% 1.44-3.63), en sujetos con historia de consumo de alcohol (OR=1.31, IC95%1.02-1.70) y en aquellos con tratamiento antihipertensivo (OR=1.29, IC95% 1.00-1.65). Conclusión: La frecuencia de síntomas de ojo seco fue altamente prevalente en la población de estudio y se asoció con sexo, tabaquismo, consumo de alcohol y medicamentos antihipertensivos.