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Do Yeh Yoon, Joo Hyun Kim, Hyun Sun Jeon, Won Ryang Wee, Joon-Young Hyon; Correlation between tear osmolarity and parameters of ocular and systemic disease in primary Sjogren's syndrome.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2680.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the relationship between tear osmolarity and parameters of ocular and systemic disease in primary Sjogren's syndrome.
Medical records of a total of 53 patients with primary Sjogren's syndrome were reviewed. Tear osmolarity using TearLab osmometer and dry eye parameters such as tear break-up time, ocular staining score (Sjögren's International Collaboration Clinical Alliance (SICCA) ocular staining score), Schirmer-I score, symptoms with Ocular Surface Disease Index (OSDI) and Visual Analog Scale (VAS) were obtained. Systemic laboratory data and medication history were also collected. Correlation between the parameters were analyzed by Spearman's rank correlation test.
53 patients with a mean age of 54.1 ± 13.2 years and female predominance (96.23%) were enrolled. Majority of patients (64%) were receiving systemic therapy for severe Sjogren’s syndrome. The tear osmolarity in Sjogren's syndrome patients was 307 ± 13.6 (mOsm/L). Higher tear osmolarity was associated with lower scores on BUT (ρ = -0.202, p=0.053), and with higher SICCA score (ρ = 0.235, p=0.019). Tear osmolarity and Schirmer test results were not correlated significantly (ρ = 0.174, p=0.631). Higher tear osmolarity was paradoxically associated with lower VAS score (ρ = -0.471, p=0.005) and lower OSDI score (ρ = -0.471, p=0.005). Neither current medication nor salivary gland focus score showed significant association with tear osmolarity. Although tear osmolarity was not associated with SSA-Ro and SSA-LA titer, serum IgG level (ρ = 0.347, p=0.003) and serum ESR (ρ = 0.277, p=0.010) level showed positive correlation with tear osmolarity.
Tear osmolarity is positively correlated with the severity of dry eye. It was associated with lower symptom severity, suggesting decreased corneal sensitivity in Sjogren's syndrome. Significant association with IgG and ESR suggests that high tear osmolarity may correlate with autoantibody load and systemic inflammatory state.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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