The Correlation of Corneal Staining with Age and Years of Disease in Sjogren's Syndrome.

Abstract

Purpose : The natural history of dry eye in Sjogren’s syndrome (SS) is poorly documented. The purpose of this multi-center retrospective chart review was to measure the relationship between corneal fluorescein staining and age and years since diagnosis in SS patients.

Methods : SS charts from 6 North American clinical sites were identified by a dry eye diagnostic code. Starting with the first visit after diagnosis of SS, variables were recorded including: age, sex, year of diagnosis, type of practitioner who diagnosed, corneal staining with fluorescein and other clinical signs. A global staining score was created (0 (no dryness)-100 (Severe dryness)), derived by melding 2 scales (0-10 and mild,moderate,severe). Data from the 1^st observed visit was analyzed. Pearson correlations between grade of corneal fluorescein staining of the worst eye and a) patient age and b) years since diagnosis were conducted by SPSS statistical package.

Results : 123 charts of SS patients were included: 115 (93.5%) female, average age 56.3 ±11.7 years (range 24 to 84 years) and average time since diagnosis 7.1_±5.1 years (n = 74; range 0 to 17 years). SS diagnosis was made by rheumatologists in 59%, family practitioners in 4%, ophthalmology in 4% and dermatology in 1% of patients with 32% unknown. Corneal staining was conducted on 98.4% and present in 69.3% of patients. Global corneal staining was documented on a scale of 0 to 100. The average corneal staining score of the worst eye was 27.99±29.26 (range 0 to 75).
There was no significant correlation between grade of corneal staining worst eye and patient age (n=117, r=-0.085, p=0.36). There was a significant correlation between grade of corneal staining worst eye and years since diagnosis (n=74, r=0.369, p=0.001).

Conclusions : In these SS patients with a wide range of age and years since diagnosis, the grade of corneal fluorescein staining of the worst eye did not correlate with patient age, but was significantly correlated with years since diagnosis. These results suggest that dry eye, as represented by corneal fluorescein staining, does progress in Sjogren’s syndrome. Further longitudinal review of these charts will establish other risk factors for dry eye severity in these patients.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.