The Efficacy of Clinical Tests to Diagnose Evaporative Dry Eye Disease Related to Meibomian Gland Dysfunction
Table 1
Efficacy study: test values and diagnostic parameters of EDED-specific and global dry eye tests.
Test parameter
EDE-specific tests
Scale range
Normal n = 26 mean (SD or IQR)
EDED n = 26 mean (SD or IQR)
AUC (95% CI)
Cut point
Sensitivity (CI); specificity (CI)
Significancea (95% CI)
Marginal signs
0–5
4 (3–5)
4 (3–5)
0.554 (0.40–0.71)
3.5
0.65 (0.47–0.83); 0.46 (0.27–0.65)
; OR 0.64 (0.21–1.97)b,c
Glands expressing
0–8
4 (2–5; (n = 20)
2 (1–4; n = 23)
0.643 (0.48–0.81)
3.5
0.70 (0.52–0.88); 0.55 (0.36–0.74)
; OR 0.66 (0.20–0.223)b,c
Gland secretion
0–3 in 0.1 unit steps
1.40 (0.6)
1.57 (0.6)
0.589 (0.44–0.74)
1.95
0.31 (0.13–0.49); 0.85 (0.71–0.99)
p (−0.53–0.13)
Gland atrophy
0–4
1.34 (0.7)
1.57 (0.7)
0.612 (0.46–0.77)
1.25
0.69 (0.51–0.87); 0.58 (0.39–0.77)
(−0.54–0.31)
Summed MGD score
0–12
6.35 (2.0)
6.94 (2.0)
0.578 (0.42–0.74)
5.35
0.81 (0.66–0.96); 0.46 (0.27–0.65)
(−1.05–1.00)b
MGD-specific questionnaire
0–174
54.1 (37)
84.1 (32)
0.739 (0.60–0.88)
80.5
0.65 (0.47–0.83); 0.75 (0.58–0.92)
(−44.8 to −3.8)
Global tests
Modified Schein survey
0–24
7.7 (4.6)
11.2 (3.9)
0.745 (0.61–0.88)
9.5
0.73 (0.56–0.90); 0.69 (0.51–0.87)
(−5.48 to −0.37)
OSDI
0–100
19.9 (16)
39.9 (23)
0.757 (0.62–0.89)
34.4
0.65 (0.47–0.83); 0.85 (0.71–0.99)
(−27.68 to −4.28)
TBUT
Cont.
12.6 (9)
3.8 (1)
0.916 (0.84–0.99)
5.95
0.92 (0.82–1.00); 0.80 (0.65–0.95)
(4.10–11.50)
NEI staining
0–33
5.1 (4)
11.9 (7)
0.822 (0.70–0.94)
7.50
0.77 (0.61–0.93); 0.81 (0.66–0.96)
(−10.1 to −3.6)
Oxford staining
0–15
4.0 (2)
7.9 (3)
0.838 (0.73–0.95)
6.5
0.73 (0.56–0.90); 0.92 (0.82–1.00)
(−5.38 to −2.04)
aNormal vs. EDED; polytomous logistic regression (ordinal data) or multivariable regression analysis (continuous data; Tukey simultaneous tests, controlled for age and gender; values adjusted for multiple comparisons). bSignificant for age ().cSignificant for sex ().
