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Fernando Morales-Wong, Karim Mohamed-Noriega, Jibran Mohamed-Noriega, Gerardo Villarreal Méndez, Jesus Mohamed, Janett Riega-Torres, Mario Alberto Garza-Elizondo; Dry eye severity and Quality of Life in Primary and Secondary Sjögren s Syndrome with standard tests and tear biomarkers.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2674. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To compare dry eye severity with conventional tests, biomarkers and quality of life (QoL) tests between patients with primary and secondary Sjögren’s syndrome (1SS y 2SS).
This is a prospective, consecutive, and transversal case series of patients with 1SS and 2SS confirmed with salivary gland biopsy, serology and/or SICCA Ocular Staining Score (SICCA OSS) according to 2012 classification criteria.The ophthalmic and dry eye evaluations were Schirmer’s test without anesthesia, tear break-up time (TBUT), tear osmolarity (Osm), esthesiometry, three Ocular Surface Staining (OSS) (Oxford, NEI-CLEK and SICCA OSS), Matrix metalloproteinase 9 (MMP9) and the Ocular Surface Disease Index (OSDI). Statistical analysis was performed with T test and Chi Square test accordingly.
We evaluated 141 eyes of 71 patients with 1SS and 48 eyes of 24 patients with 2SS, Mean age ± standard deviation (SD) was 52.62 ± 12.90 and 55.58 ± 9.83 years respectively. Mean ± SD in 1SS and 2SS were as follow: TBUT 4.53 ± 2.16 vs 5.73 ± 4.16, Schirmer’s test 9.93 ± 9.6 vs 13.81 ±11.26, esthesiometry 5.65 ± 1.0 vs 5.53 ± 1.3, Osm 319.58 ±24.70 vs 311.78 ± 24.63, SICCA OSS 7.233 ± 3.46 vs 6.19 ± 3.40, Oxford 5.28 ± 3.28 vs 4.16 ± 3.17, NEI-CLEK 5.50 ± 3.95 vs 4.00 ± 4.12, OSDI 44.69 ± 24.59 vs 44.24 ± 22.73, DEQ5 11.63 ± 4.84 vs 11.09 ± 5.24, VFQ25 73.88 ±20.23 vs 72.87 ± 20.89. MMP9 were positive in 37 (26.42%) and 11(22.91%) eyes in primary SS and secondary SS respectably.The following tests were significantly more severe in 1SS: TBUT (p=0.01), Schirmer's test (p 0.02), Oxford (p=0.04 ) and NEI-CLEK (p=0.02). the other tests, including Osm, MMP9, SICCA OSS and the QoL tests were not significantly different between 1SS and 2SS.
Mean Osm showed a non-significant tendency to be higher in 1SSThe percentage of eyes with positive MMP9 was similar in 1SS and 2SS. Qol tests were similar between both groups. Only the standard tests of TBUT and Schirmer were significantly higher in 1SS. The OSS Oxford and NEI CLEK were significantly higher in 1SS, whereas OSS SICCA was not significantly different between groups.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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