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B. Caffery, T. Simpson, S. Wang, University Health Network Multidisciplinary Sjogren's Syndrome Clinic, University of Toronto; Rose Bengal Staining Differentiates Primary and Secondary Sjogren’s Syndrome and Keratoconjunctivitis Sicca. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3390.
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To compare the clinical presentation of 231 patients with primary Sjogren’s syndrome (pSS), 58 patients with secondary Sjogren’s syndrome (sSS) and 89 keratoconjunctivitis sicca (KCS) patients, to determine those procedures that best differentiate these groups in a multidisciplinary setting.
The records of all patients seen at the University Health Network Sjogren’s Syndrome Clinic from October 1992 to July 2006 were reviewed and documented. Patients were diagnosed as primary and secondary SS by the American European consensus criteria (AECC) of 2002. Those patients seen at the clinic who were not diagnosed with SS and who had symptoms of dry eye and Schirmer scores of <= 10 mm in 5 minutes in at least one eye were included as aqueous deficient dry eye controls (KCS). There were 89 variables used in the analysis. Recursive partitioning was used to create a classification tree that demonstrated which characteristics best distinguished the three groups from each other.
The presence of anti-ro antibodies was the most important variable in distinguishing the three groups. Rose bengal staining of 3/9 or greater and positive salivary flow results were the most important non-invasive variables that distinguished pSS, sSS and KCS.
Eye care practitioners can help to identify and differentiate pSS, sSS and KCS by using rose bengal staining and testing salivary flow.
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