Article Text

Download PDFPDF

Reliability and validity of the Japanese version of the Ocular Surface Disease Index for dry eye disease
  1. Akie Midorikawa-Inomata1,
  2. Takenori Inomata1,2,3,
  3. Shuko Nojiri4,
  4. Masahiro Nakamura5,
  5. Masao Iwagami6,
  6. Keiichi Fujimoto7,
  7. Yuichi Okumura3,7,
  8. Nanami Iwata7,
  9. Atsuko Eguchi1,
  10. Hitomi Hasegawa2,
  11. Hikaru Kinouchi8,
  12. Akira Murakami2,
  13. Hiroyuki Kobayashi1
  1. 1 Department of Hospital Administration, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
  2. 2 Department of Ophthalmology, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
  3. 3 Department of Strategic Operating Room Management and Improvement, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
  4. 4 Department of Medical Technology Center, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
  5. 5 Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
  6. 6 Department of Health Services Research, University of Tsukuba, Tsukuba, Ibaraki, Japan
  7. 7 Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
  8. 8 School of Cultural and Creative Studies, Aoyama Gakuin University, Shibuya-ku, Tokyo, Japan
  1. Correspondence to Dr Takenori Inomata; tinoma{at}


Objectives The Ocular Surface Disease Index (OSDI) questionnaire is widely used to evaluate subjective symptoms of dry eye disease (DED) as a primary diagnostic criterion. This study aimed to develop a Japanese version of the OSDI (J-OSDI) and assess its reliability and validity.

Design and setting Hospital-based cross-sectional observational study.

Participants A total of 209 patients recruited from the Department of Ophthalmology at Juntendo University Hospital.

Methods We translated and culturally adapted the OSDI into Japanese. The J-OSDI was then assessed for internal consistency, reliability and validity. We also evaluated the optimal cut-off value to suspect DED using an area under the receiver operating characteristic curve (AUC) analysis.

Primary outcome measures Internal consistency, test–retest reliability and discriminant validity of the J-OSDI as well as the optimal cut-off value to suspect DED.

Results Of the participants, 152 had DED and 57 did not. The J-OSDI total score showed good internal consistency (Cronbach's alpha=0.884), test–retest reliability (interclass correlation coefficient=0.910) and discriminant validity by known-group comparisons (non-DED, 19.4±16.0; DED, 37.7±22.2; p<0.001). Factor validity was used to confirm three subscales within the J-OSDI according to the original version of the questionnaire. Concurrent validity was assessed by Pearson correlation analysis, and the J-OSDI total score showed a strong positive correlation with the Dry Eye-Related Quality-of-Life Score (γ=0.829). The optimal cut-off value of the J-OSDI total score was 36.3 (AUC=0.744).

Conclusions The J-OSDI was developed and validated in terms of reliability and validity as an effective tool for DED assessment and monitoring in the Japanese population.

  • dry eye disease
  • ocular surface disease index
  • OSDI
  • reliability
  • validity

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

View Full Text

Statistics from


  • Twitter @eyetake

  • Contributors AM-I: performance of the research, data collection, data analysis and writing of the paper. TI: performance of the research, research design, data analysis and writing of the paper. SN and MI: research design, data analysis. MN: data analysis. FK, YO, NI, AE and HH: data collection, data analysis. HKi: performance of the research. AM and HKo: research design, writing of the paper.

  • 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 None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Independent Ethics Committee at Juntendo University Hospital (approval number, 17–088 and 18–141).

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

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.