Effect of Sodium Sucrose-Sulfate on the Ocular Surface of Patients with Keratoconjunctivitis Sicca in Sjögren’s Syndrome

Author(s):  
Jan U. Prause ◽  
Kirsten Bjerrum ◽  
Sven Johansen
1996 ◽  
Vol 10 (1) ◽  
pp. 9-12 ◽  
Author(s):  
S.C. Pflugfelder

The pre-ocular tear film is a complex biochemical structure produced by the lacrimal glands and epithelial cells on the ocular surface. Clinical syndromes of ocular irritation may result from deficiencies in one or more of these layers. At a recent dry eye workshop at the National Eye Institute, dry eye conditions were classified into those with adequate aqueous tear production and those with aqueous tear deficiency. The majority of patients with aqueous adequate dry eye suffer from meibomian gland dysfunction that results in lipid tear deficiency. Aqueous tear deficiency can be subclassified into non-Sjogren's syndrome and Sjogren's syndrome (SS) groups. Patients with non-Sjögren's aqueous tear deficiency have less-severe symptoms and ocular surface disease than those with SS. The etiology of non-Sjögren's aqueous tear deficiency has not been established, but it appears to be multifactorial. In SS, immune-mediated destruction of the lacrimal gland results in severe aqueous tear deficiency. Aqueous tear deficiencies lead to ocular surface disease, termed keratoconjunctivitis sicca (KCS). KCS results from abnormal terminal differentiation of the ocular surface epithelia and is associated with marked reduction in mucin production by these cells. Clinical features helpful in differentiating the various dry eye syndromes are reviewed.


2020 ◽  
Vol 21 (23) ◽  
pp. 9112
Author(s):  
Sharmila Masli ◽  
Darlene A. Dartt

Sjögren’s syndrome (SS) is a systemic rheumatic disease that predominantly affects salivary and lacrimal glands resulting in oral and ocular dryness, respectively, referred to as sicca symptoms. The clinical presentation of ocular dryness includes keratoconjunctivitis sicca (KCS), resulting from the inflammatory damage to the ocular surface tissues of cornea and conjunctiva. The diagnostic evaluation of KCS is a critical component of the classification criteria used by clinicians worldwide to confirm SS diagnosis. Therapeutic management of SS requires both topical and systemic treatments. Several mouse models of SS have contributed to our current understanding of immunopathologic mechanisms underlying the disease. This information also helps develop novel therapeutic interventions. Although these models address glandular aspects of SS pathology, their impact on ocular surface tissues is addressed only in a few models such as thrombospondin (TSP)-1 deficient, C57BL/6.NOD.Aec1Aec2, NOD.H2b, NOD.Aire KO, and IL-2Rα (CD25) KO mice. While corneal and/or conjunctival damage is reported in most of these models, the characteristic SS specific autoantibodies are only reported in the TSP-1 deficient mouse model, which is also validated as a preclinical model. This review summarizes valuable insights provided by investigations on the ocular spectrum of the SS pathology in these models.


Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1260
Author(s):  
Sneha Centala ◽  
Joyce H. Park ◽  
Diana Girnita

Sjogren’s syndrome is classically characterized by symptoms of keratoconjunctivitis sicca and xerostomia, secondary to lymphocytic infiltration of the salivary and lacrimal glands. Cutaneous findings of this disease are infrequently discussed and thus rarely considered among patients without the typical symptomatology. However, these patients can develop xerosis, alopecia, vitiligo, papular or nodular lesions, or cutaneous vasculitis. A 56-year-old Asian female presented with intermittent cutaneous erythematous lesions of her bilateral pinna and preauricular areas. Despite initial symptom presentation causing concern for tumid lupus versus cutaneous T cell lymphoma versus relapsing polychondritis, extensive serologic and histopathologic workup eventually indicated a likely diagnosis of Sjogren’s syndrome. This case brings to light that Sjogren’s syndrome is truly a multi-systemic disease and can present with primarily extra glandular cutaneous symptoms. When approaching the workup of a new patient, it is absolutely vital to maintain a broad differential and keep in mind that overlap syndromes among multiple autoimmune diseases do exist as well.


2001 ◽  
Vol 11 (3) ◽  
pp. 227-232 ◽  
Author(s):  
J. Murube ◽  
L. Chenzhuo ◽  
E. Murube ◽  
L. Rivas ◽  
O. Shalaby

Purpose To present a new indicator that measures the sulci of the lacrimal lake of the eye according to the degrees of ocular abduction at which they vanish. This new approach will help determine the severity and progression of mucosal retraction in ocular surface diseases. Methods A total of 181 eyes of 94 healthy persons, 130 eyes of 65 patients with Sjögren's syndrome, and 30 eyes of 15 patients with ocular pemphigoid were examined using the slit lamp. We recorded the vanishing point of the three main lacunar sulci (plico-bulbar, plico-caruncular and dermo-caruncular) while abducting. Results In healthy persons, the average vanishing points for the first and second lacunar sulci were respectively, 53.2° ± 12.3 and 54.5° ± 9.8. In patients with Sjögren's syndrome, 49.53° ± 10.81 and 53.17° ± 7.28 and in patients with incipient ocular cicatricial pemphigoid, 42.69° ± 14.33 and 44.46° ± 16.85. Statistical significance was p < 0.005. Conclusions The lacunar sulci are shallower and vanish sooner in ocular cicatricial pemphigoid and Sjögren syndrome than in normals. Investigating the vanishing point of the lacunar sulci while abducting is useful for grading the shrinkage of the conjunctiva, caruncle and medial canthus.


1997 ◽  
Vol 81 (6) ◽  
pp. 435-438 ◽  
Author(s):  
A A Kruize ◽  
O P van Bijsterveld ◽  
R J Hene ◽  
P C M de Wilde ◽  
T E W Feltkamp ◽  
...  

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