Abstract
Purpose :
To carry out comprehensive comparative examination of a Norwegian cohort of patients with primary Sjögren’s syndrome (pSS) and age- and gender-matched controls.
Methods :
Thirty-four female patients with pSS (age 53±12) and 32 controls (age 49±11.5) were recruited to the study. All participants underwent comprehensive dry eye and dry mouth examinations. Ophthalmological examinations included McMonnies and Ocular Surface Disease Index (OSDI) questionnaires, and clinical dry eye tests – tear osmolarity, Schirmer I test, tear film break-up time (TFBUT), ocular surface staining (OSS) and meibomian glands drop-out assessed with meibography. Dry mouth examinations included the summated xerostomia inventory (SXI) and clinical oral dryness score (CODS). Secretion rate of unstimulated (UWS) and stimulated whole saliva (UWS) was recorded. Mann-Whitney U test was used for inter-group comparisons, while Spearmans rank correlation was applied to search for possible correlations.
Results :
Compared to the control group, pSS patients had higher McMonnies (17.6±3.8 vs 4.1±2.0, p<0.01) and OSDI scores (34.8±19.2 vs 4.8±7.5, p<0.01), higher tear osmolarity level (334.8±21.6 vs 319.7±15.8, p<0,01) lower Schirmer I value (4.8±4.0 vs 16.2±11.6, p<0.01), shorter TFBUT (2.4±2.6 vs 5.4±3.3, p<0,01) and higher OSS (3.9±2.3 vs 0.8±1.2, p<0.01). Additionally, the pSS group represented with higher level of meibomian gland drop out score in the upper eyelids (1.8±0.9 vs 1.4±0.6, p=0.043) and the lower eyelids (1.4±0.7 vs 1.1±0.3, p=0.006). Patients with pSS also demonstrated more severe oral dryness as shown by higher mean SXI score (12.1±2.5 vs 5.9±1.0, p<0.01), CODS (4.9±2.0 vs 0.6±0.9, p<0.01), decreased levels of UWS (0.07±0.07 vs 0.29±0.17 ml/min, p<0.01) and SWS (0.58±0.40 vs 1.49±0.67 ml/min, p<0.01). Moderate correlations between SWS and Schirmer I test (r=0.56, p=0.03), SXI and McMonnies questionnaires (r=0.456, p=0.04) were observed.
Conclusions :
The findings of the current study revealed positive correlations between dry eye and dry mouth symptoms as well as lacrimal and salivary secretion underlining that interdisciplinary evaluation of pSS patients provides better understanding of the disease.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.