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Assessment of patient burden from dry eye disease using a combination of five visual analogue scales and a radar graph: a pilot study of the PENTASCORE
  1. Marc Labetoulle1,2,
  2. Jérémie Benichou1,
  3. Nabila M’nafek1,
  4. Flavie Garnier3,
  5. Ghislaine Rabut3,
  6. Wassim Ben Hadj Salah1,
  7. Antoine Labbé3,4,5,
  8. Antoine Rousseau1,2,
  9. Christophe Baudouin3,4,5
  1. 1Service d'Ophtalmologie, Hôpital Bicêtre, APHP, Université Paris Sud, Le Kremlin-Bicêtre, France
  2. 2Center for Immunology of Viral infections and Autoimmune diseases. IDMIT Infrastructure, CEA,Université Paris Sud, Fontenay-aux-Roses Cedex, France
  3. 3Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, Paris, France
  4. 4Institut de la Vision, Sorbonne Université, INSERM, CNRS, Paris, France
  5. 5Department of Ophthalmology, Ambroise Paré Hospital, AP-HP, Université de Versailles Saint-Quentin en Yvelines, Boulogne-Billancourt, France
  1. Correspondence to Marc Labetoulle, Ophtalmology, Hopital Bicetre, Le Kremlin-Bicetre, Île-de-France 94275, France; marc.labetoulle{at}


Background/aims Dry eye disease (DED) questionnaires would ideally be easy and fast to answer and explore the main aspects of disease burden and satisfaction (efficacy and tolerability) with treatment. This pilot study evaluates the Pentascore questionnaire for routinely assessing DED.

Methods The Pentascore combines five visual analogue scales (VAS) to assess the intensity and frequency of ocular pain/discomfort, the impact of DED on daily activities and visual tasks and the efficacy and tolerability of ongoing DED treatment(s). This retrospective study compared Pentascore to the Ocular Surface Disease Index (OSDI) questionnaire, fluorescein tear break-up-time, corneal staining and Schirmer I test.

Results For 161 DED patients, the algebraic mean (±SE) for the Pentascore was 52.6±1.8, the mean standardised area of the radar graph was 32.1±1.7 (out of 100) and the mean score for the OSDI was 52.6±1.8. Both questionnaires were highly statistically correlated (R=0.74 for both algebraic score and radar area, p<0.001), and each of five Pentascore VAS was significantly correlated with the OSDI (p<0.05). Corneal staining score (CSS) was correlated with two Pentascore VAS (impact of DED on daily activities and visual tasks), and there was a trend towards a correlation between CSS and the area of the radar graph (p=0.09).

Conclusions This pilot study indicates that the Pentascore can rapidly and effectively assess the burden of DED and satisfaction with treatments. Compared with the algebraic mean, the estimation of the area of the radar graph likely improves the sensitivity for detecting differences/changes in symptoms and treatment follow-up.

  • cornea
  • diagnostic tests/investigation
  • inflammation
  • lacrimal gland
  • ocular surface

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  • Contributors ML, JB, AR, CB and WBHS revised the literature and drafted the manuscript. NM, ML, CB, AR, GF, RG and AB conceived, supervised and revised the manuscript. All authors provided critical revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests ML has served as a consultant for Allergan, Alcon, Bausch and Lomb, MSD, Santen/Novagali and Théa. AL served as a consultant for Alcon, Novartis, Santen, Laboratories Théa, Allergan, and Bausch & Lomb. AR served as a consultant for Thea, Horus Pharma, Pfizer, Allergan, personal Alnylam. The remaining authors have nothing to disclose.

  • Patient consent for publication Not required.

  • Ethics approval Institutional Review Board (IRB)/Ethics Committee of the Société Française d’Ophtalmologie approved this study. As this was a retrospective study, the IRB did not require a number for the study, only a written letter granting consent for the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data available upon request.

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