To evaluate the diagnostic performance of corneal and conjunctival staining, and lid wiper epitheliopathy (LWE) in detecting dry eye disease, as defined by the global consensus Tear Film and Ocular Surface Society Dry Eye Workshop II (TFOS DEWS II) criteria. A total of 2066 community residents (1285 females; mean ± SD age, 40 ± 19 years) were recruited in an investigator-masked, prospective registry-based, diagnostic accuracy study. Dry eye symptomology and ocular surface parameters were assessed in a single clinical session. The Sjögren's International Collaborative Clinical Alliance (SICCA) corneal and conjunctival staining scoring and Korb lid wiper epitheliopathy (LWE) grading were evaluated by an independent masked assessor. Overall, 807 (39 %) participants fulfilled the TFOS DEWS II criteria for dry eye disease, of which 178 (9 %) participants were classified as moderate-to-severe disease. The discriminative abilities of superior and inferior LWE (C-statistics, 0.724 and 0.712, respectively) were greater than corneal and conjunctival staining (C-statistics, 0.573 and 0.627, respectively). The Youden-optimal diagnostic cut-offs for the SICCA corneal and conjunctival staining scores were both ≥1, and the optimal thresholds for the Korb superior and inferior LWE grades were both ≥1. LWE was more commonly detected in both mild-to-moderate and moderate-to-severe dry eye disease, and demonstrated more consistent correlation with other ocular surface parameters across a broader range of disease severity. LWE demonstrates superior diagnostic performance relative to corneal and conjunctival staining. These findings would support the routine incorporation of LWE evaluation as part of the diagnostic workup of dry eye disease.

中文翻译：

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干眼病中眼表面染色和眼睑擦拭器上皮病的区分表现：一项研究者掩盖的、基于前瞻性登记的诊断准确性研究


旨在评估角膜和结膜染色以及眼睑擦拭器上皮病 (LWE) 在检测干眼病方面的诊断性能，如全球共识泪膜和眼表协会干眼研讨会 II (TFOS DEWS II) 标准所定义。一项由研究者隐藏、基于登记的前瞻性诊断准确性研究共招募了 2066 名社区居民（1285 名女性；平均±SD 年龄，40±19 岁）。在单次临床会议中评估干眼症状和眼表参数。 Sjögren 国际合作临床联盟 (SICCA) 角膜和结膜染色评分以及 Korb 眼睑擦拭器上皮病变 (LWE) 分级由独立的蒙面评估员进行评估。总体而言，807 名 (39%) 参与者符合 TFOS DEWS II 干眼病标准，其中 178 名 (9%) 参与者被归类为中度至重度疾病。上、下 LWE 的辨别能力（C 统计量分别为 0.724 和 0.712）大于角膜和结膜染色（C 统计量分别为 0.573 和 0.627）。 SICCA 角膜和结膜染色评分的 Youden 最佳诊断临界值均≥1，Korb 上、下 LWE 等级的最佳阈值均≥1。 LWE 在轻度至中度和中度至重度干眼病中更常见，并且在更广泛的疾病严重程度中与其他眼表参数具有更一致的相关性。相对于角膜和结膜染色，LWE 表现出卓越的诊断性能。这些发现将支持将 LWE 评估常规纳入干眼病诊断检查的一部分。