Abstract
Purpose :
To assess the long-term clinical outcomes of dry eye patients suspected of Sjögren’s syndrome (SS) who received serologic testing for three tissue-specific autoantibodies: anti-carbonic anhydrase 6 (CA6), anti-salivary gland protein 1 (SP1), and anti-parotid secretory protein (PSP).
Methods :
Medical records between 2014-2019 were reviewed for 316 dry eye patients who presented at a tertiary academic medical center and received serologic testing for tissue-specific antibodies for suspicion of underlying SS. Patients with a minimum of 3 years follow-up included. Conjunctival lissamine green staining, corneal fluorescein staining, Schirmer’s test without anesthesia, and tear osmolarity were recorded for the worst eye at baseline and final clinic visits.
Results :
A total of 103 patients with a mean follow-up of 54.7 months were included. Forty-four patients (42.7%) tested positive for tissue-specific antibodies at baseline visit (24 positive for anti-CA6, 10 for anti-SP1, and 17 for anti-PSP) and were included in the antibody-positive group. The remaining 59 were included in the antibody-negative group. At baseline, 3 in the antibody-positive group (1 positive for anti-CA6 and 2 positive for anti-PSP) and 7 in the antibody-negative group were diagnosed with SS based on positive anti-SSA and/or positive minor salivary gland biopsy. Prevalence of SS was not different between the tissue-specific antibody-positive versus negative groups at baseline (%7 vs. %12, P>.05). Two additional patients in the antibody-positive group (1 positive for anti-CA6 and anti-PSP and 1 positive for anti-CA6) and 1 in the antibody-negative group were diagnosed with SS during the follow-up (4% vs. 2%, P>.05). Mean values for objective dry eye parameters at baseline and final visit did not show a statistically significant difference between groups regardless of tissue-specific antibody status.
Conclusions :
Tissue-specific autoantibodies did not indicate severe dry eye disease in this longitudinal cohort. However, two patients with tissue-specific antibodies developed SS during the follow-up, albeit the sample size was not large enough. Perhaps the follow-up duration was not long enough to suggest that tissue-specific antibodies are early markers for SS. A larger prospective study with a longer follow-up and repeat serological testing is warranted.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.