Assessment of Relationships between Subjective and Objective Signs of Ocular Dryness in Sjögren Syndrome

Abstract

Abstract: : Purpose: To assess the correlation between objective and subjective signs of ocular dryness in patients suffering from Sjögren syndrome, in order to determine which signs are clearly relevant in clinical research on ocular dryness. Methods: 34 consecutive patients (including 31 females) suffering from Sjögren syndrome according to international criteria were assessed for objective signs of ocular dryness, including blinking rate, tear break up time, fluorescein and lissamine green staining, Schirmer I and phenol read thread tests. Patients were also independently ask to estimate their ocular discomfort using a visual analogue scale (VAS). Results: A statistically significant correlation (p < 0.05) was found between the VAS and Schirmer I or phenol red thread results, whereas no correlation was found between VAS and other objective tests. Conclusions: Our results did not confirm that ocular discomfort in ocular dryness is clearly related to the grade of kerato-conjunctivitis sicca, e.g. the level of corneal and conjunctival staining with either fluorescein or lissamine green. Only watering, assessed by Schirmer I and phenol red thread tests, was correlated to patient's ocular dryness feeling. This argues for keeping Schirmer I test as a main criterion for diagnosis of Sjögren syndrome.

Keywords: cornea: tears/tear film/dry eye • lacrimal gland • keratitis