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Hayette Rebika, Sihem Lazreg; Ocular surface in Sjögren’s syndrome. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5446.
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Sjögren syndrome is a chronic inflammatory disorder characterized by exocrine gland dysfunction and a systemic course. Lymphocytic infiltration of the lacrimal and salivary glands results in the classic sicca complex characterized by dry eyes and dry mouth. This prospective study aimed to describe the ocular and biological features of patients with Sjögren syndrome in an Algerian population.
Prospective study of 78 patients with dry eye syndrome, examined between September 2010 and November 2012. All patients underwent complete ophthalmological examination, including a Schirmer test, fluorescein and lissamine green staining, immune serum assessment and salivary gland biopsy. In addition to their treatment prescribed by the rheumatologist, they were treated with lacrimal substitutes and punctual plugs.
The population was principally females (n = 75). The mean age was 45.4+/- 12.6 years old. At the first visit, the patients presented with mean Oxford and OSDI scores of 6 ±1.8 and 76.2 ± 10.2 respectively. The mean Schirmer test was 4.5 ± 1.5. Furthermore, 40% of patients presented with filamentous keratitis. The compromised ocular surface induced 5 cases of blindness (in both eyes in one case and in one eye in 4 cases). Association with rheumatoid arthritis was found in 42% of cases. The SSG was primary in 1/3 of patients. SSA and SSB antibodies were detected respectively in 85% and 89% of patients. In these compromised patients, punctual plugs insertion led to a decrease of about 50% on the frequency of use of lacrimal substitutes.
In Algerian population, Sjögren’s syndrome is a serious disease, with an impact on the quality of life due to corneal involvement that is often very severe and sometimes irreversible. In spite of correct systemic treatment (plaquenil, corticosteroids, pilocarpine), the ocular surface alterations occur. In Sjogren’s disease, symptoms of dry eye are most often associated with an deleterious impact on vision-related quality of life.
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