title: Changes in dry eye diagnostic status following implementation of revised Japanese dry eye diagnostic criteria.
abstract: OBJECTIVE
  Our aim was to evaluate changes in dry eye diagnostic status following implementation of the new dry eye diagnostic criteria in Japan.
  
  
  METHODS
  This was a multicenter cross-sectional study.
  
  
  METHODS
  We recruited 295 individuals (81 men, 214 women, average age 43.6 ± 14.3 years) seen for general ophthalmic checkup and dry eye examinations. Using results of the Schirmer I test, tear breakup time, and fluorescein and Rose Bengal staining, patients were diagnosed as having definite dry eye (DDE), probable dry eye (PDE), or as being normal according to both the old and new Japanese dry eye diagnostic criteria.
  
  
  RESULTS
  Mean ages of normal participants and patients with PDE and DDE were 37.0 ± 10.4, 41.7 ± 14.4, and 47.7 ± 15.3 years, respectively (p < 0.001). All 37 individuals diagnosed as normal following the old criteria were also diagnosed as normal with the new diagnostic criteria. Among the 60 patients diagnosed as PDE with the old criteria, 19 (31.7%) were diagnosed as normal and 41 (68.3%) as PDE with the new diagnostic criteria. Of the 198 patients diagnosed with DDE following the old criteria, 59 (29.7%) were diagnosed as PDE and 139 (70.2%) as DDE with the new diagnostic criteria. There was no significant difference in dry eye severity index scores between the old and new diagnostic criteria.
  
  
  CONCLUSIONS
  A shift in the final dry eye diagnostic status from DDE to PDE and from PDE to normal was observed with the implementation of the new dry eye diagnostic criteria, suggesting that patients at the severe end of the dry eye disease spectrum are now diagnosed as DDE disease under the new criteria.
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Uchino
authors.forename: Miki
authors.initials: M
authors.lastname: Uchino
authors.forename: Murat
authors.initials: M
authors.lastname: Dogru
authors.forename: Samantha
authors.initials: S
authors.lastname: Ward
authors.forename: Norihiko
authors.initials: N
authors.lastname: Yokoi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsubota
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003941:Diagnostic Techniques, Ophthalmological; D004185:Disability Evaluation; D015352:Dry Eye Syndromes / Q000175:diagnosis*; D005260:Female; D019793:Fluorescein; D019983:Guideline Adherence; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012395:Rose Bengal; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D013666:Tears / Q000502:physiology; D055815:Young Adult
chemical_list: D012395:Rose Bengal; D019793:Fluorescein
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