Current patterns in the use of diagnostic tests in dry eye evaluation
Current patterns in the use of diagnostic tests in dry eye evaluation
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DOI：
10.1097/qai.0b013e3181605b95
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发表时间：
2008-07-01
期刊：
影响因子：
2.8
通讯作者：
Baldwin, Edward K.
中科院分区：
文献类型：
--
作者：
Smith, Janine;Nichols, Kelly K.;Baldwin, Edward K.
目的：通过描述一组专家医师的使用，阐明客观体征和主观症状在干眼诊断和治疗中的作用。干眼症的体征和症状并不总是相关良好，目前有一些争议的理想角色的体征和症状，他们在临床practice.Methods：一个平衡的小组的16名参与者在一个科学的圆桌会议上干眼回顾了4例患者的案例研究和完成调查排名常见的诊断程序评估症状和体征的顺序，他们将被使用。症状评估是主要的诊断方法。在初始检查中最常用的客观测试是泪膜破裂时间（93%）、角膜染色（85%）、泪膜评估（76%）、结膜染色（74%）和Schirmer测试（54%）。大多数专家组成员使用多个测试，与中位数为6个测试中使用的初步examination.Conclusions：主观症状和客观体征都是重要的干眼的诊断和管理，与病人的症状和病史起着至关重要的作用。大多数临床医生在干眼管理中使用客观体征。然而，目前可用的诊断测试与症状严重程度不可靠相关。需要进行旨在开发准确、客观、响应性的干眼严重程度测量方法的研究。
Purpose: To clarify the roles of objective signs and subjective symptoms in the diagnosis and management of dry eye by describing their use by a group of expert practitioners. Dry eye signs and symptoms do not always correlate well, and there is currently some controversy over the ideal roles of signs and symptoms and their actual use in clinical practice.Methods: A balanced panel of 16 participants in a scientific roundtable on dry eye reviewed 4 patient case studies and completed surveys ranking common diagnostic procedures assessing symptoms and signs by the order in which they would be used.Results: Symptom assessment was the predominant diagnostic method. The objective tests most commonly used during the initial examination were tear breakup time (93%), corneal staining (85%), tear film assessment (76%), conjunctival staining (74%), and the Schirmer test (54%). Most panelists used multiple tests, with a median of 6 tests used in the initial examination.Conclusions: Subjective symptoms and objective signs are both important in the diagnosis and management of dry eye, with the patient's symptoms and history playing a critical role. Most clinicians use objective signs in dry eye management. However, currently available diagnostic tests do not correlate reliably with symptom severity. Research aimed at developing accurate, objective, responsive measures of dry eye severity is needed.