FAST® questionnaire for identifying glaucoma patients at risk for ocular surface disease

Area of Science:

• Ophthalmology
• Clinical Epidemiology
• Ocular Surface Disease Research

Background:

• Ocular surface disease (OSD) is a common complication in patients with glaucoma or ocular hypertension (OHT).
• Early identification of OSD risk in these patients is crucial for timely intervention and management.
• Existing screening tools may not be optimized for rapid clinical assessment.

Purpose of the Study:

• To validate and assess the reliability of the Fast Assessment of the Ocular Surface Trouble (FAST®) questionnaire.
• To develop and refine shorter versions of the FAST® questionnaire for efficient clinical use.
• To identify glaucoma and OHT patients at risk of developing OSD.

Main Methods:

• A multicenter, international, cross-sectional epidemiological survey was conducted.
• Rasch analysis and LASSO methods were employed to reduce items from the initial 14-item FAST® questionnaire.
• Sensitivity, specificity, and ROC curves were used to evaluate the diagnostic performance of the FAST® versions for OSD detection.

Main Results:

• The study analyzed 2308 eyes from 1154 patients.
• The initial FAST® indicated 60% of subjects had OSD.
• A 6-item FAST® version demonstrated 71.9% sensitivity and 74.3% specificity for OSD detection, with an AUC of 0.815.

Conclusions:

• The FAST® questionnaire is a valid and reliable instrument for clinical practice and trials.
• Shortened FAST® versions facilitate rapid identification of patients with glaucoma or OHT at risk of dry eye.
• The FAST® questionnaire aids in the early detection of OSD in at-risk populations.