Prevalence and predictors of Sjögren's syndrome in a prospective cohort of patients with aqueous-deficient dry eye

Melissa Liew, Min Zhang, Elizabeth Kim, Esen K Akpek

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1498-1503
Number of pages6
JournalBritish Journal of Ophthalmology
Volume96
Issue number12
DOIs
StatePublished - Dec 2012

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Rheumatoid Factor
Antinuclear Antibodies
Antibodies
Staining and Labeling
Fluorescein
Tears
Multicenter Studies
Consensus
Industry
Referral and Consultation
Anesthesia
Clinical Trials
Surveys and Questionnaires

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience
  • Medicine(all)

Cite this

Prevalence and predictors of Sjögren's syndrome in a prospective cohort of patients with aqueous-deficient dry eye. / Liew, Melissa; Zhang, Min; Kim, Elizabeth; Akpek, Esen K.

In: British Journal of Ophthalmology, Vol. 96, No. 12, 12.2012, p. 1498-1503.

Research output: Contribution to journalArticle

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abstract = "Aims: To assess the prevalence and determine predictors of Sj{\"o}gren'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 (Sj{\"o}gren-specific antibody A (SSA), Sj{\"o}gren-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.",
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