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Lindsay Rothfield, Sasha Hubschman, Mario Rojas, Raquel Goldhardt, Anat Galor; ASSOCIATION BETWEEN EARLY SJOGREN MARKERS AND SYMPTOMS AND SIGNS OF DRY EYE. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2762.
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© ARVO (1962-2015); The Authors (2016-present)
Early markers of Sjögren’s disease—SP-1, PSP, and CA6 antibodies—are more accurate signs of early Sjögren’s when compared to classic markers (anti-Ro and anti-La antibodies). There is a knowledge gap of the relationship between these early markers and dry eye (DE). Here, we compare symptoms and signs of DE in subjects who tested positive versus negative for early markers of Sjögren’s (Sjö).
In this study, patients seen in the Miami VA Eye Clinic who were tested for early markers of Sjögren’s underwent a standard ocular surface examination. This included questionnaires (Dry Eye Questionnaire (DEQ5), Ocular Surface Disease Index (OSDI), Neuropathic Pain Symptom Inventory (NPSI-E)), InflammaDry evaluation, tear break up time, corneal staining, assessment of pain after anesthetic eye drops, and Schirmer with anesthesia. A systematic review of the patient’s medical record was performed. The main outcome measure was a comparison of DE symptoms and signs in Sjö positive versus negative subjects. Statistical tests used were Chi Square test, independent sample t-test, and correlations, as appropriate.
Of 28 subjects tested for Sjö, 19 (68%) were positive for one or more markers. The markers most commonly elevated were CA6 IgM (17.217±12.126) and SP1 IgA (14.021±13.885). There were no significant differences in gender, race, ethnicity, or DE symptoms and signs between Sjö positive and negative subjects. Subjects with positive markers were significantly less likely to suffer from hypertension (n=1, 5.3% vs n=5, 55.6%, p=.007), and more likely to have required treatment escalation past artificial tears (AT) (n=19, 100% vs n=6, 66.7%, p=.026) including topical cyclosporine or lifitegrast (n=18, 100% vs n=6, 66.7%, p=.029) prior to the initial visit. Sjö positive vs negative individuals were also more likely to have had an inadequate response to cyclosporine (n=11, 64.7% vs n=1, 5.88%, p=.035). Some DE symptoms positively correlated with marker levels: DEQ5 score with PSP IgG (rho=0.458, p=0.024) and SP1 IgG (rho=0.452, p=0.027). Others showed negative correlations: OSDI score with PSP IgM (r=0.515, p=0.029) and evoked pain to light with SP1 IgA (r=0.476, p=0.046) and SP1 IgM (r=0.539, p=0.021).
Differences were noted between Sjö positive and negative individuals with DE. Future studies are needed to understand how to incorporate Sjö data into the care of individuals with DE.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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