Making the diagnosis of Sjögren's syndrome in patients with dry eye

Clinical Ophthalmology
Kenneth A BeckmanMark S Milner

Abstract

Sjögren's syndrome (SS) is a chronic and progressive systemic autoimmune disease that often presents initially with symptoms of dry eye and dry mouth. Symptoms are often nonspecific and develop gradually, making diagnosis difficult. Patients with dry eye complaints warrant a step-wise evaluation for possible SS. Initial evaluation requires establishment of a dry eye diagnosis using a combination of patient questionnaires and objective ocular tests, including inflammatory biomarker testing. Additional work-up using the Schirmer test and tear film break-up time can differentiate between aqueous-deficient dry eye (ADDE) and evaporative dry eye. The presence of ADDE should trigger further work-up to differentiate between SS-ADDE and non-SS-ADDE. There are numerous non-ocular manifestations of SS, and monitoring for SS-related comorbid findings can aid in diagnosis, ideally in collaboration with a rheumatologist. The clinical work-up of SS can involve a variety of tests, including tear function tests, serological tests for autoantibody biomarkers, minor salivary gland and lacrimal gland biopsies. Examination of classic SS biomarkers (SS-A/Ro, SS-B/La, antinuclear antibody, and rheumatoid factor) is a convenient and non-invasive way ...Continue Reading

Citations

Dec 19, 2017·BioMed Research International·Gloria Romina RossPaola Gauffin Cano
Jul 29, 2018·Pediatric Rheumatology Online Journal·Ausra SnipaitieneLina Jankauskaite
Sep 7, 2018·Clinical Reviews in Allergy & Immunology·Juan-Manuel AnayaRubén D Mantilla
Jun 25, 2021·Frontiers in Medicine·Claudio VitaliNicoletta Del Papa

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Methods Mentioned

BETA
flow cytometry
biopsy
ELISA

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