scholarly journals Ocular Surface Disease in Sjögren's Syndrome: Management in a Scleral Lens Clinical Practice

2020 ◽  
Vol 4 (1) ◽  
pp. e12-e22
Author(s):  
Daddi Fadel ◽  
Melissa Barnett
Keyword(s):  
Quality Of Life ◽  
Sjögren’S Syndrome ◽  
Dry Eye ◽  
Ocular Surface ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Autologous Serum ◽  
Sjögren‘S Syndrome

Sjögren’s syndrome is a chronic, autoimmune, systemic disease characterized by lymphocytic infiltration and malfunction of the exocrine glands, primarily the lacrimal and salivary glands, resulting in predominant symptoms of dry eye and dry mouth. Sjögren’s syndrome is a highly prevalent condition and is one of the most common systemic, rheumatic, autoimmune diseases, affecting up to 1.4% of adults in the United States, second only to rheumatoid arthritis in its prevalence in North America. Primary Sjögren’s syndrome has shown to affect patients’ health-related quality-of-life due to dryness, chronic pain, depression, anxiety,physical and mental fatigue, and neuropsychiatric symptoms. Scleral lenses (SLs) have shown to be significantly beneficial in relieving symptoms and improvingquality-of-life in patients with Sjögren’s syndrome and dry eye disease. SLs may be used concurrently with the other therapies including ocular lubricants, eyelid hygiene, punctal occlusion, topical prescription medications, and autologous serum. This manuscript reviews the implication of Sjögren’s syndrome on the ocular surface and quality-of-life and describes how SLs, in combination with other treatments, may be beneficial.

scholarly journals Economic burden and loss of quality of life from dry eye disease in Canada

2021 ◽  
Vol 6 (1) ◽  
pp. e000709
Author(s):  
Clara Chan ◽  
Setareh Ziai ◽  
Varun Myageri ◽  
James G Burns ◽  
C Lisa Prokopich
Keyword(s):  
Quality Of Life ◽  
Disease Severity ◽  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Indirect Costs ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Eye Disease ◽  
Sjögren‘S Syndrome

ObjectiveTo describe the direct and indirect cost estimates of dry eye disease (DED), stratified by disease severity, and the impact of DED on quality of life (QoL) in Canadian patients.Methods and analysisA prospective, multicentre, observational, cross-sectional study was conducted at six sites across Canada. Eligible patients completed a 20 min survey on demography, general health, disease severity, QoL and direct (resource utilisation and out-of-pocket expenses for the past 3–24 months) and indirect costs (absenteeism and presenteeism based on Work Productivity and Activity Impairment questionnaire responses). Subgroup analyses were performed according to DED severity and presence of Sjögren’s syndrome.ResultsResponses from 146 of 151 participants were included in the analysis. DED was rated as moderate or severe by 19.2% and 69.2% of patients, respectively. Total mean annual costs of DED were $C24 331 (Canadian dollars) per patient and increased with patient-reported disease severity. Mean (standard deviation [SD]) indirect costs for mild, moderate and severe disease were $C5961 ($C6275), $C16 525 ($C11 607), and $C25 485 ($C22,879), respectively. Mean (SD) direct costs were $C958 ($C1216), $C1303 ($C1574) and $C2766 ($C7161), respectively. QoL scores were lowest in patients with Sjögren’s syndrome (8.2% of cohort) and those with severe DED.ConclusionThis study provides important insights into the negative impact of DED in a Canadian setting. Severe DED was associated with higher direct and indirect costs and lower QoL compared with those with mild or moderate disease. Increased costs and poorer QoL were also evident for patients with DED plus Sjögren’s syndrome versus DED alone.

Bacterial Distribution On The Ocular Surface of Patients With Primary Sjögren’s Syndrome

2021 ◽  
Author(s):  
Yong Chan Kim ◽  
Bak Noon Ham ◽  
Kui Dong Kang ◽  
Jun Myeong Yun ◽  
Man Jae Kwon ◽  
...  
Keyword(s):  
Sjögren’S Syndrome ◽  
Dry Eye ◽  
Ocular Surface ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Rrna Genes ◽  
Group A ◽  
Group B ◽  
Sjögren‘S Syndrome

Abstract Many studies have shown that gut microbial dysbiosis is a major factor in the etiology of autoimmune diseases but none have suggested that the ocular surface (OS) microbiome is associated with Sjögren’s syndrome (SS). In this prospective study, we analyzed bacterial distribution on the OS in patients with primary SS. Among the 120 subjects included in this study, 48 patients (group A) had primary SS, whereas 72 subjects (group B) had dry eye symptoms that were unrelated to SS. We evaluated clinical dry eye parameters such as the OS disease index, ocular staining score, Schirmer’s test, and tear break-up time. Conjunctival swabs were used to analyze the microbial communities from the two groups. Bacterial 16S rRNA genes were sequenced using the Illumina MiSeq platform, and the data were analyzed using the QIIME 1.9.1 program. The Shannon index was significantly lower in group A than in group B microbiota. An analysis of similarity using the Bray–Curtis distance method found no difference in beta-diversity between the two groups. In group A, Actinobacteria at the phylum level and Corynebacteria at the genus level exhibited low abundance, but the differences were not statistically significant. SS apparently decreases the diversity of the OS microbial community and may affect the abundance of some bacterial strains at the phylum and genus levels. These observations may be important for the pathophysiology of SS and should be investigated in future studies.

What Ophthalmologists Should Know About Sjögren’s Syndrome

2010 ◽  
Vol 04 (01) ◽  
pp. 77 ◽  
Author(s):  
Canan Asli Utine ◽  
Esen K Akpek ◽  
◽  
◽  
Keyword(s):  
Salivary Gland ◽  
Sjögren’S Syndrome ◽  
Dry Eye ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Autologous Serum ◽  
Eye Symptoms ◽  
Dry Eye Symptoms ◽  
Sjögren‘S Syndrome

About one-quarter of patients with dry-eye syndrome (DES) have an underlying rheumatic condition, most commonly Sjogren’s syndrome (SS). SS is a common, frequently underdiagnosed cause of dry eye with multisystemic involvement. The immunological background of SS involves activation of both innate and acquired immune systems. According to the 2002 American and European classification systems, presence of any four of the six criteria (i.e. symptoms of dry eye, symptoms of dry mouth, ocular signs of dry eye, objective salivary gland involvement, typical histopathology findings in minor salivary gland biopsy specimens and presence of serum autoantibodies) as long as either the biopsy or serology is positive or presence of any three of the four objective criteria is considered diagnostic of SS. The main goal of treatment of ocular involvement is the alleviation of dry-eye symptoms with replacement therapy, stimulation of tear secretion and supportive surgical procedures to conserve tears. Preservative-free tear substitutes, topical steroids, cyclosporine A, autologous serum eye-drops and punctal plugs are commonly used for this purpose.

Dry Eye and Clinical Disease of Tear Film, Diagnosis and Management

2014 ◽  
Vol 07 (02) ◽  
pp. 109
Author(s):  
Vasilis Achtsidis ◽  
Eleftheria Kozanidou ◽  
Panos Bournas ◽  
Nicholas Tentolouris ◽  
Panos G Theodossiadis ◽  
...  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Contact Lenses ◽  
Sjögren's Syndrome ◽  
Tear Film ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Tear Production ◽  
Sjögren‘S Syndrome

Dry eye disease (DED) is a clinically significant multifactorial disorder of the ocular surface and tear film as it results in ocular discomfort and visual impairment and predisposes the cornea to infections. It is important for the quality of life and tends to be a chronic disease. It is also common, as the prevalence is estimated between 5 % to 30 % and this increases with age. Therefore, it is recognized as a growing public health problem that requires correct diagnosis and appropriate treatment. There are two main categories of DED: the deficiency of tear production (hyposecretive), which includes Sjögren’s syndrome, idiopathic or secondary to connective tissue diseases (e.g. rheumatoid arthritis), and non-Sjögren’s syndrome (e.g. age-related); and the tear evaporation category, where tears evaporate from the ocular surface too rapidly due to intrinsic causes (e.g. meibomian gland disease or eyelid aperture disorders) or extrinsic causes (e.g. vitamin A deficiency, contact lenses wear, ocular allergies). Management of the disease aims to enhance the corneal healing and reduce patient’s discomfort. This is based on improving the balance of tear production and evaporation by increasing the tear film volume (lubrication drops) and improving quality of tear film (ex omega-3 supplements, lid hygiene, tetracyclines), reducing the tear film evaporation (paraffin ointments, therapeutic contact lenses), reducing tear’s drainage (punctal plugs, cautery), and finally by settling down the ocular surface inflammation (steroids, cyclosporine, autologous serous), as appropriate. In this article we will review the clinical presentation, differential diagnosis, and treatment options for DED.

scholarly journals Thrombospondin-1 Is Necessary for the Development and Repair of Corneal Nerves

2018 ◽  
Vol 19 (10) ◽  
pp. 3191 ◽  
Author(s):  
Yukako Tatematsu ◽  
Qalbi Khan ◽  
Tomas Blanco ◽  
Jeffrey Bair ◽  
Robin Hodges ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Sjögren’S Syndrome ◽  
Dry Eye ◽  
Ocular Surface ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Corneal Nerves ◽  
Thrombospondin 1 ◽  
Sjögren‘S Syndrome

Thrombospondin-1-deficient (TSP-1−/−) mice are used as an animal model of Sjögren’s Syndrome because they exhibit many of the symptoms associated with the autoimmune type of dry eye found in primary Sjögren’s Syndrome. This type of dry eye is linked to the inflammation of the lacrimal gland, conjunctiva, and cornea, and is thought to involve dysfunction of the complex neuronal reflex arc that mediates tear production in response to noxious stimuli on the ocular surface. This study characterizes the structural and functional changes to the corneal nerves that are the afferent arm of this arc in young and older TSP-1−/− and wild type (WT) mice. The structure and subtype of nerves were characterized by immunohistochemistry, in vivo confocal microscopy, and confocal microscopy. Cytokine expression analysis was determined by Q-PCR and the number of monocytes was measured by immunohistochemistry. We found that only the pro-inflammatory cytokine MIP-2 increased in young corneas of TSP-1−/− compared to WT mice, but tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1), and macrophage inflammatory protein-2 (MIP-2) all increased in older TSP-1−/− mouse corneas. In contrast, CD11b+ pro-inflammatory monocytes did not increase even in older mouse corneas. Calcitonin gene-related peptide (CGRP)-, but not Substance P (SubP)-containing corneal nerves decreased in older, but not younger TSP-1−/− compared to WT mouse corneas. We conclude that CGRP-containing corneal sensory nerves exhibit distinct structural deficiencies as disease progresses in TSP-1−/− mice, suggesting that: (1) TSP-1 is needed for the development or repair of these nerves and (2) impaired afferent corneal nerve structure and hence function may contribute to ocular surface dysfunction that develops as TSP-1−/− mice age.

Swallowing Disorders in Sjögren’s Syndrome: Prevalence, Risk Factors, and Effects on Quality of Life

Dysphagia ◽  
2015 ◽  
Vol 31 (1) ◽  
pp. 49-59 ◽  
Author(s):  
Jenny L. Pierce ◽  
Kristine Tanner ◽  
Ray M. Merrill ◽  
Karla L. Miller ◽  
Katherine A. Kendall ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Swallowing Disorders ◽  
Sjögren‘S Syndrome
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