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Use of Phenol Red Thread Test as a rescue test in diagnostic strategy of severe ocular syndrome
Author(s) -
LABETOULLE M,
GENDRON G,
POGORZALEK N,
KASWIN G,
MARIETTE X,
DE MONCHY I
Publication year - 2010
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2010.310.x
Subject(s) - phenol red , thread (computing) , test (biology) , medicine , ophthalmology , computer science , biology , chemistry , chromatography , operating system , paleontology
Purpose To define a combination between Schirmer I and phenol red thread test (PRT) that improves the screening of patients with ocular sicca syndrome. Methods The PRT test was performed before (PRT1) and after (PRT2) the Schirmer I test, in both eyes of 143 patients complaining of ocular dryness secondary to Sjögren’s syndrome (SGS) or Sicca Asthenia Polyalgia Syndrome (SAPS) (72 and 71 patients respectively), and in 40 patients with no sign of dry eye. Groups were matched by age and gender. After determining the best cut‐off values using the ROC procedure, several combinations of PRT and Schirmer I were assessed to improve the predictive values of the procedure. Results The best cut‐off value for PRT2, estimated at 15mm, provided a satisfying match between sensitivity and specificity indexes (68% and 90% respectively), similar to those obtained with the Schirmer I test. If PRT1 alone was ineffective to screen SGS from control patients, the comparison between PRT 1 and PRT2 (”delta‐PRT”) was found as a good marker to detect patients with persistent tear reflex. The combination of positive Schirmer I, PRT 2 and/or delta‐PRT tests was found as highly predictive of severe ocular sicca syndrome. Conclusion The combination of Schirmer I and PRT test improves the screening procedure to detect patients with severe ocular dryness. Since PRT test is non‐invasive and time‐effective, it could be more widely used in daily clinical practice, besides Shirmer I test, to optimize the work‐up of patients presenting with dry‐eye subjective signs.