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David Cui, Priya Mathews, Sezen Karakus, Esen K Akpek; Long-Term Ocular Outcomes of Sjogren’s Syndrome vs Non-Sjogren’s Dry Eye Disease. Invest. Ophthalmol. Vis. Sci. 2020;61(7):118.
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To compare the longitudinal clinical treatments and ocular findings in primary Sjogren’s Syndrome (SS) and non-Sjogren’s Syndrome dry eye patients.
All patients were evaluated and followed at the Johns Hopkins Hospital, a tertiary academic medical center between 2004-2019, and had one clinic visit per calendar year for a minimum of 5 years. Primary SS patients were identified through an existing database from the Johns Hopkins Sjogren’s Syndrome Center, and non-Sjogren’s patients were identified using ICD codes for dry eye syndrome/keratoconjunctivitis sicca. Primary SS patients fulfilled the American College of Rheumatology’s 2012 criteria, requiring 2 of the following: positive serum anti-SSA and/or anti-SSB, ocular staining score ≥3, and presence of focal lymphocytic sialadenitis in labial salivary gland biopsy. A retrospective chart review was performed of each patient from their initial visit to all subsequent follow-ups.
One hundred randomly selected patients were included, with 50 Sjogren’s and 50 non-Sjogren’s patients with dry eyes caused by all other etiologies. The average patient age at initial presentation was 53.1 +/- 13.8 years, with an average follow-up period of 7.4 +/- 3.0 years.Sjogren’s patient used on average 6.9 separate dry eye treatments, compared to non-Sjogren’s patients with 5.8 treatments and 4.7 on follow-up. Eighty-two percent (41/50) of SS patients received additional treatment for Sjogren’s either as systemic medication or saliva production stimulator.Average Ocular Staining Score for Sjogren’s and non-Sjogren’s patients on presentation was 5.1 and 4.9 respectively for the worse eye on presentation, with the score decreasing/improving by 2.0 for both groups by their most recent visit. During the follow-up period, eighteen (36%) of Sjogren’s patients and 10 (20%) non-Sjogren’s patients had a dry eye related ocular complication.
Patients with chronic dry eye disease require the utilization and trial of multiple treatments, eventually helping improve objective measurements of dry eye over time. Response to treatment was similar between the two groups, however Sjogren’s patients may have marginally worse findings such as a worse staining score at baseline, utilizing more dry eye treatments, and a greater prevalence of dry eye complication on follow-up.
This is a 2020 ARVO Annual Meeting abstract.
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