A recent study published in Cornea, led by researchers from the Keio University School of Medicine in Tokyo, Japan, identified clinical features of Sjögren’s syndrome (SS)-related dry eye disease (DED) using anterior segment images.
Give me some background first.
DED is a frequent complication of autoimmune disorders such as SS, ocular graft-versus-host disease, and other rheumatic diseases.
Previous studies have shown that conjunctival lissamine staining tends to be elevated, and temporal and nasal conjunctival staining patterns are observed in SS patients.
Now talk about the study.
In this retrospective investigation, researchers performed inferior corneal fluorescein and lissamine green staining on 502 patients with autoimmune disorders as well as controls.
The breakdown of patients included:
- SS: 68 cases
- Ocular graft-versus-host disease: 50 cases
- Other conditions: 27 cases
- Simple DED: 72 cases
- No DED: 97 cases
Findings?
The research team noted that the inferior corneal fluorescein staining score (CFS_I) was significantly higher in the SS group (P<0.001).
Additionally, the nasal lissamine green staining score (LG_N) was high in the SS group (P<0.001). The investigators concluded that the inferior cornea and nasal conjunctiva were more damaged than the superior and/or central cornea.
Expert opinion?
According to the study authors, “Our results are supported by previous reports, which showed that clinical conjunctival lissamine green staining is related to the pathology of SS.”
They added that nasal lissamine staining could be the most important diagnostic test as multiple studies have demonstrated that inferior corneal staining is a key corneal zone for predicting different dry eye subtypes.
Take home.
Positive CFS_I and LG_N correlate with a high risk of SS for patients.
As such, positive results from these tests are valuable signs for eye care practitioners to look out for when treating a patient that is suspected of having immune-related DED, particularly SS.
These tests may be useful for the early detection of SS-related DED.