June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Sjögren Syndrome in the Brazilian Population: Demographic, Clinical, Laboratory and Imaging Profile
Author Affiliations & Notes
  • Eduardo M Rocha
    Ophthalmology, FMRP-USP, Ribeirao Preto, Brazil
  • Carolina Maria Modulo
    Ophthalmology, FMRP-USP, Ribeirao Preto, Brazil
  • Amanda Pires Barbosa
    Ophthalmology, FMRP-USP, Ribeirao Preto, Brazil
  • Fabiola Reis Oliveira
    Clinical Medicine, FMRP-USP, Ribeirão Preto, SP, Brazil
  • Flavio Calil Petean
    Clinical Medicine, FMRP-USP, Ribeirão Preto, SP, Brazil
  • Alfredo Ribeiro Silva
    Pathology, FMRP-USP, Ribeirão Preto, SP, Brazil
  • Jorge Leon Esquiche
    FORP-USP, Ribeirão Preto, SP, Brazil
  • Denny Marcos Garcia
    Ophthalmology, FMRP-USP, Ribeirao Preto, Brazil
  • Valdair Francisco Muglia
    Clinical Medicine, FMRP-USP, Ribeirão Preto, SP, Brazil
  • Paulo Louzada
    Clinical Medicine, FMRP-USP, Ribeirão Preto, SP, Brazil
  • Footnotes
    Commercial Relationships   Eduardo Rocha, Johnson&Johnson (C); Carolina Modulo, None; Amanda Barbosa, None; Fabiola Oliveira, None; Flavio Petean, None; Alfredo Silva, None; Jorge Esquiche, None; Denny Garcia, None; Valdair Muglia, None; Paulo Louzada , None
  • Footnotes
    Support  CAPES, CNPq, FAPESP, FAEPA
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2676. doi:
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      Eduardo M Rocha, Carolina Maria Modulo, Amanda Pires Barbosa, Fabiola Reis Oliveira, Flavio Calil Petean, Alfredo Ribeiro Silva, Jorge Leon Esquiche, Denny Marcos Garcia, Valdair Francisco Muglia, Paulo Louzada; Sjögren Syndrome in the Brazilian Population: Demographic, Clinical, Laboratory and Imaging Profile. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2676.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Sjögren syndrome (SS) is an autoimmune disease present worldwide. This work describes an extensive series of SS patients observed in Brazil and compared the data among SS and non-SS (NSS) patients, including MRI analysis of lacrimal (LG) and parotid (PG) glands.

Methods : We evaluated a spontaneous sample of individuals with sicca symptoms and classified as SS or NSS. The demographic, clinical, and laboratory data were analyzed. The OSDI, PhQ-9, and neuropathic pain questionnaires were also applied. Thirty-nine controls and 19 SS individuals were submitted to MRI on the 3.0 Tesla Magnetic Resonance Scanner. Images were analyzed for volume, the signal intensity ratio of LG and vitreous (LG/V), the signal intensity ratio of the ipsilateral PG to vitreous (PG/V) and apparent diffusion coefficient (ADC) of LG and PG (DWI sequence with b=1000 mm/s2).

Results : One hundred-twenty-three completed and were classified as SS or NSS (84 and 44, respectively). The mean age is 52 ± 15 years old, and 95 % are women. The groups have a similar frequency of dry eye and dry mouth. The positivity for ANF, SSa, SSb and focus score are high in SS compared to NSS groups (p<0.05, Chi-square test). Values of Schirmer test, TFBUT, and salivary flow were lower, and corneal staining score was higher in SS compared to NSS group (p<0.05). Ocular findings presented similar mean levels between women and men in the SS and NSS groups. The OSDI showed higher score mean in SS patients (p=0.0014), but PhQ-9 and the neuropathic pain questionnaire were similar in both groups. LG volume in the MRI was larger in young SS patients compared to age-matched controls (p=0,03). The signal intensity ratio of LG/V, PG/V and ADC of LG were significantly higher in the SS group (p=0.01 and p=0.003, respectively, Tukey’s test). There was a positive correlation between corneal fluorescein staining and the signal intensity ratio of LG (r=0.63 e p=0.003) and PG (r=0.53 e p=0.01) (Pearson Correlation Coefficient).

Conclusions : Our data confirms the world parameters for SS. It also reveals that MRI of LG and PG identify changes in SS patients and these findings correlate with punctate keratitis. Depressive symptoms and neuropathic pain need further investigation in conjunction with the clinical signs to determine the potential distinctive causes and better treatment for SS and NSS sicca syndrome.

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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