Comparison of physician-assessed and patient-reported outcomes of using azithromycin eye drops in the treatment of bacterial blepharitis.

PURPOSE: To compare physician-assessed and patient-reported outcomes quantified with the Japanese Ocular Surface Disease Index (J-OSDI) following the treatment of bacterial blepharitis and to evaluate the utility of the J-OSDI.

STUDY

DESIGN

Multicenter prospective observational study.

METHODS

Physicians assessed symptoms and findings, calculating clinical total scores at baseline (T0), 7 (T1) and 14 (T2) days post-treatment with 1% azithromycin ophthalmic solution, and 1 month after discontinuation (T3). Patients self-reported symptoms using the J-OSDI at these times. The J-OSDI score trends and differences in temporal changes between the J-OSDI and clinical total scores were analyzed by use of a linear mixed-effects model.

RESULTS

Forty-six eyes (46 patients; mean age, 71.8 years) were studied. The J-OSDI scores decreased significantly post-treatment for all the patients, with similar trends for both anterior and posterior blepharitis. For all the patients, the slope difference between the J-OSDI and clinical total scores was not significant in the T0-T1 period (P = .219), meaning that the J-OSDI scores reflected the clinical results, whereas it was significant in the T1-T2 (P = .004) and T2-T3 (P <.001) periods. The within-subject correlation between the 2 scores was 0.525 (95% CI 0.401-0.631). For anterior blepharitis, the slope differences were significant across all the periods, but for posterior blepharitis, no significant differences were observed in the T0-T1 or T1-T2 (P = .205, 0.06, respectively) periods, although significant differences were noted in the T2-T3 period (P = .018).

CONCLUSION

The J-OSDI trajectory often diverges from physician-rated changes. Whilst the J-OSDI does not assess treatment response in anterior blepharitis, it may be partially reflective of improvement in posterior blepharitis.