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M. Labetoulle, G. Dubernard, C. Baudouin, R. Adam, X. Mariette, H. Offret; Comparison of Ocular Dryness Between Patients Affected by Sjögren Patients and Those Affected by SAPS (Sicca Asthenia Polyalgia Syndrome) . Invest. Ophthalmol. Vis. Sci. 2006;47(13):237.
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To compare the mean values of tests for ocular dryness in patients affected by Sjögren's syndrome (SS) and in those affected by SAPS (Sicca Asthenia Polyalgia Syndrome), which is characterized by symptoms of sicca syndrome with no biochemical marker of auto–immune disease (no serum auto–antibody, normality of biopsy of salivary glands).
147 consecutive patients presenting a sicca syndrome within the framework of a suspicion of Sjögren syndrome were included in the study. The quantification of the lachrymal function was realized by successively: i) the tear break–up time; ii) the corneal and conjunctival staining with fluorescein and lissamine green; iii) the phenol red thread test; iv) the Schirmer I test. The patients underwent the same day a multidisciplinary evaluation of the sicca syndrome (complete clinical and biologic examination among which evaluation of the eye discomfort using an analogical visual scale, measure of the salivary stream, and biopsy of salivary glands).
The diagnosis of Sjögren's disease was retained in 65 patients and SAPS was confirmed in 82 patients. While the eye discomfort and salivary stream were similar in both groups of patients, the objective ocular dryness was significantly more important in Sjögren patients. To distinguish the two syndromes, the tear break–up time was the most sensitive (0,89) while the corneal staining with fluorescein was the most specific (0,93).
The Sicca Asthenia Polyalgia Syndrome, very close to the Sjögren's disease as for subjective symptoms, leads to a less severe objective ocular dryness. This likely reflects the lack of auto–immune deregulation, characterizing this syndrome, in particular the lack of inflammatory infiltration of the exocrine glands.
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