TY - JOUR
T1 - Prevalence and predictors of Sjögren's syndrome in a prospective cohort of patients with aqueous-deficient dry eye
AU - Liew, Melissa
AU - Zhang, Min
AU - Kim, Elizabeth
AU - Akpek, Esen K.
PY - 2012/12
Y1 - 2012/12
N2 - Aims: To assess the prevalence and determine predictors of Sjögren's syndrome (SS) in patients with clinically significant aqueous-deficient dry eye. Methods: Patients enrolled in an industry-sponsored, multicentre clinical trial (NCT00784719) were assessed prospectively for the presence of SS. Ocular testing included Schirmer test, corneal fluorescein staining, conjunctival lissamine green staining, and tear-film breakup time. Review of systems questionnaire, medical history, dry eye questionnaire and laboratory work-up (Sjögren-specific antibody A (SSA), Sjögren-specific antibody B (SSB), rheumatoid factor (RF) and antinuclear antibody (ANA)) were obtained. Results: Of 327 patients, 38 (11.6%) had SS: 21 (6.4%) with primary SS ( pSS), and 17 (5.2%) with secondary SS. Nine patients (3%) were newly diagnosed using the applied diagnostic criteria based on American-European consensus criteria. Patients with SS had significantly worse conjunctival and corneal staining, Schirmer test (with and without anaesthesia), and symptoms compared with patients without SS. pSS Was significantly more likely to occur in patients with positive ANA (OR: 13.9) and RF (OR: 4.8). Conclusions: Ophthalmologists caring for patients with clinically significant dry eye should have a high index of suspicion for underlying SS and low threshold for serological work-up. RF and ANA are recommended as useful tests in SSA/SSB-negative patients for further diagnostic referral.
AB - Aims: To assess the prevalence and determine predictors of Sjögren's syndrome (SS) in patients with clinically significant aqueous-deficient dry eye. Methods: Patients enrolled in an industry-sponsored, multicentre clinical trial (NCT00784719) were assessed prospectively for the presence of SS. Ocular testing included Schirmer test, corneal fluorescein staining, conjunctival lissamine green staining, and tear-film breakup time. Review of systems questionnaire, medical history, dry eye questionnaire and laboratory work-up (Sjögren-specific antibody A (SSA), Sjögren-specific antibody B (SSB), rheumatoid factor (RF) and antinuclear antibody (ANA)) were obtained. Results: Of 327 patients, 38 (11.6%) had SS: 21 (6.4%) with primary SS ( pSS), and 17 (5.2%) with secondary SS. Nine patients (3%) were newly diagnosed using the applied diagnostic criteria based on American-European consensus criteria. Patients with SS had significantly worse conjunctival and corneal staining, Schirmer test (with and without anaesthesia), and symptoms compared with patients without SS. pSS Was significantly more likely to occur in patients with positive ANA (OR: 13.9) and RF (OR: 4.8). Conclusions: Ophthalmologists caring for patients with clinically significant dry eye should have a high index of suspicion for underlying SS and low threshold for serological work-up. RF and ANA are recommended as useful tests in SSA/SSB-negative patients for further diagnostic referral.
UR - http://www.scopus.com/inward/record.url?scp=84869874313&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84869874313&partnerID=8YFLogxK
U2 - 10.1136/bjophthalmol-2012-301767
DO - 10.1136/bjophthalmol-2012-301767
M3 - Article
C2 - 23001257
AN - SCOPUS:84869874313
SN - 0007-1161
VL - 96
SP - 1498
EP - 1503
JO - British Journal of Ophthalmology
JF - British Journal of Ophthalmology
IS - 12
ER -