Evaluation of patients with dry eye for the presence of primary or secondary Sjӧgren’s syndrome

Nashwa M Abd-Allah,1 Amal Aly Hassan,1 Gihan Omar,1 Mona Hamdy,1 Sahar Torky A Abdelaziz,2 Waleed Mahmoud Abd El Hamid,3 Rabab A Moussa4 1Rheumatology and Rehabilitation Department, Faculty of Medicine, Minia University, Minia, Egypt; 2Ophthalmology Department, Faculty of Medicine, Minia University,...

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Autores principales: Abd-Allah NM, Hassan AA, Omar G, Hamdy M, Abdelaziz STA, Abd El Hamid WM, Moussa RA
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2019
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Acceso en línea:https://doaj.org/article/dd0f4b9cca87443aa75ce261b03d8340
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Sumario:Nashwa M Abd-Allah,1 Amal Aly Hassan,1 Gihan Omar,1 Mona Hamdy,1 Sahar Torky A Abdelaziz,2 Waleed Mahmoud Abd El Hamid,3 Rabab A Moussa4 1Rheumatology and Rehabilitation Department, Faculty of Medicine, Minia University, Minia, Egypt; 2Ophthalmology Department, Faculty of Medicine, Minia University, Minia, Egypt; 3Clinical Pathology Department, Faculty of Medicine, Minia University, Minia, Egypt; 4Pathology Department, Faculty of Medicine, Minia University, Minia, EgyptCorrespondence: Nashwa M Abd-AllahRheumatology and Rehabilitation Department, Faculty of Medicine, Minia University, New Minia City, first district, Youssef El-Sbaie Street, building (1), Minia 61511, EgyptTel +20 111 667 2116Email abdallahnashwa@yahoo.comPurpose: To assess the frequency of Sjӧgren’s syndrome (SS), either primary or secondary to rheumatic disease, in a cohort of patients with aqueous-deficient dry eye and to determine the most accurate objective test for diagnosis of SS.Methods: A total of 111 patients with dry eye were recruited from Minia University’s ​Ophthalmology Outpatient Clinic (69 patients) and Rheumatology Outpatient Clinic (42 patients). The patients were screened for aqueous tear–deficient dry eye by abnormal test results of Schirmer test I (<10 mm) and tear-film break-up time (<10 seconds) in at least one eye. The diagnosis of SS was made according to the 2012 American College of Rheumatology​ criteria. A complete work up for SS was performed, including clinical examination, serological tests, ocular tests, and labial salivary–gland biopsy (LSGB).Results: Of the 111 patients, 58 had aqueous-deficient dry eye: 23 in the ophthalmology clinic cohort (group I) and 35 in the rheumatology clinic cohort (group II). Three patients had pSS, and its frequency was 13% in group I and 5.2% among all studied patients. The ocular staining score is the most diagnostic ocular test (sensitivity 100% and specificity 90.9%). Anti-SSA/Ro antibody is the most accurate serological method (sensitivity 33.3% and specificity 100%). LSGB histopathology is the most diagnostic method for SS, with sensitivity, specificity, and positive and negative predictive values of 100%.Conclusion: SS was detected with reasonable frequency among dry-eye patients, particularly pSS. Screening of dry eye for SS can select SS patients early in the disease course.Keywords: dry eye, Sjӧgren’s syndrome, rheumatic disease, ocular staining score, OSS, labial salivary–gland biopsy, LSGB