Abstract
Purpose :
The purpose of this descriptive study was to measure corneal epithelial thickness (CET) in Sjogren’s disease (SjD) patients.
Methods :
A retrospective chart review was conducted on SjD patients from the University of Pennsylvania Scheie Eye Institute Dry Eye Clinic from September 2021 to January 2022. Patient demographics, treatment, Ocular Surface Disease Index (OSDI), and exam, such as visual acuity, corneal signs, and conjunctival signs, were extracted. CET from both eyes was measured with the Optovue RTVue-XR Avanti OCT System (Visionix, Fremont, CA) and the central 3mm and concentric 5mm, 7mm, and 9mm zones were recorded for the superior (S), temporal, inferior (I), and nasal quadrants. S average, I average, maximum, minimum, and map standard deviation (MSD) were automatically calculated. Statistical analysis was performed to assess the relationship between these values, clinical characteristics, and symptoms among SjD patients.
Results :
15 SjD patients were included (mean age 58.4 years). All were female and 80% were Caucasian. 10 were SS-A or SS-B positive and 5 met SjD diagnostic criteria with a salivary gland biopsy. 73% were RF positive and 60% were ANA positive. Among CET values, MSD (3.8um) was significantly inversely correlated with the Schirmer test (r = -0.39, p = 0.0047), but was not with OSDI (r=-0.16, p=0.39). All other values were not significantly correlated with Schirmer or OSDI. Mean concentric zone values included S9mm (44.1um), S7mm (45.8um), S5mm (49.8um), central (52.6um), I5mm (53.7um), I7mm (52.5um), and I9mm (50.1um). All titer levels did not correlate with any CET values. OSDI was significantly lower in ANA positive compared to negative patients (43.1 vs. 67.9, p=0.01). All other titers were not significantly associated with Schirmer or OSDI.
Conclusions :
To our knowledge, this is the first study of SjD patients with CET mapping, demonstrating a correlation between decreased Schirmer measurements and a higher MSD of CET. This study’s measurements are similar to prior studies of nonspecific dry eye patients. Edorh et al reported significant thinning in nonspecific dry eye CET of S9mm (≈47um) and I9mm (≈50um) compared to normal controls of about 49um and 52um respectively. Our corresponding SjD specific CET S9mm (44.1um) and I9mm (50.1um) show similar thinning. Further studies are needed to understand the relationship of CET with objective and subjective measurements of SjD and other etiologies of dry eye disease.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.