scholarly journals Efficacy of Intense Pulsed Light Treatment in Patients with Sjögren’s Syndrome Associated with Meibomian Gland Dysfunction

2021 ◽  
Vol 62 (12) ◽  
pp. 1581-1591
Author(s):  
Ja Young Moon ◽  
Hyeon Jeong Yoon ◽  
Kyung-Chul Yoon
Keyword(s):  
Ocular Surface ◽  
Sjögren's Syndrome ◽  
Tear Film ◽  
Sjogren’S Syndrome ◽  
Meibomian Gland ◽  
Sjogren's Syndrome ◽  
Lipid Layer ◽  
Staining Score ◽  
Surface Staining ◽  
Sjögren‘S Syndrome

Purpose: To investigate the efficacy of intense pulsed light (IPL) treatment in patients with meibomian gland dysfunction (MGD) associated with Sjögren’s syndrome.Methods: This study included 43 patients with MGD and Sjögren’s syndrome. Patients received either IPL with meibomian gland expression (IPL/MGX) (n = 22) or MGX only (n = 21). Treatments were administered three times at a 3-week interval. Patients were followed up 6 weeks after the end of the treatment. Ocular Surface Disease Index (OSDI), tear film breakup time with fluorescein dye (FBUT), non-invasive tear breakup time, tear meniscus height (TMH), Schirmer test, SICCA ocular surface staining score, meibum quality score (MQS), and meibum expression score (MES) were evaluated at each visit. Meibomian gland dropouts (meiboscore) and tear film lipid layer grade were measured using keratography.Results: OSDI, FBUT, corneal surface staining score, MQS, meiboscore, and tear film lipid layer grade improved after IPL/MGX treatment (p < 0.05). In both treatment groups, MES significantly improved (p < 0.01 and p < 0.05 for IPL/MGX and MGX groups, respectively). The Schirmer test score, conjunctival surface staining score, and TMH after treatment were not significantly different between the groups. After treatment, the IPL/MGX group had significantly lower OSDI, FBUT, corneal staining score, MQS, and MES, but higher FBUT, compared with the MGX group (p < 0.05).Conclusions: IPL treatment effectively improved tear film, ocular surface parameters, meibomian gland function, and lipid layer grade in patients with Sjögren’s syndrome and MGD.

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 Analysis of the first tear film break-up point in Sjögren’s syndrome and non-Sjögren’s syndrome dry eye patients

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Songjiao Zhao ◽  
Qihua Le
Keyword(s):  
Sjögren’S Syndrome ◽  
Dry Eye ◽  
Ocular Surface ◽  
Sjögren's Syndrome ◽  
Tear Film ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Fluorescein Staining ◽  
Break Up ◽  
Sjögren‘S Syndrome

Abstract Background Tear film instability plays an important role in the course of Sjögren’s Syndrome dry eye (SSDE) even though it is generally classified as aqueous-deficient dry eye. The measurement of the first tear film break-up point (FTBUP) helps to evaluate the most unstable position of the tear film on ocular surface. We aim to investigate FTBUP in Sjögren’s Syndrome dry eye (SSDE) and non-Sjögren’s Syndrome dry eye (NSSDE) patients, and explore its correlation with dry eye indices. Methods Twenty-two SSDE patients (44 eyes) and 22 NSSDE patients (44 eyes) were enrolled in the study. Oculus Keratograph K5M was used to measure FTBUP, the first and average non-invasive keratographic breakup time (f-NIKBUT and av-NIKBUT), the tear meniscus height, and meibomian gland dropout. Other tests of tear film were also performed including Ocular Surface Dryness Index (OSDI), Schirmer I test, fluorescein break-up time and corneal fluorescein staining. Dry eye indices and the locations of the FTBUP were compared between SSDE and NSSDE patients. Generalized estimating equation (GEE) was used to ajusted the correlations between right and left eyes. The correlations between the FTBUP and ocular symptoms and signs were investigated using Pearson’s correlation coefficient test. Results The FTBUP occurred at the supranasal quadrant in 12/88 eyes, supratemporal quadrant in 8/88 eyes, inferonasal quadrant in 34/88 eyes, and inferotemporal quadrant in 34/88 eyes. The percentage eyes with inferior FTBUP was significantly higher in the SSDE than in the NSSDE subjects (86.3% vs 68.1%, P = .049). Moreover, in SSDE subjects, temporal breakup point was seen more often in those who presented corneal fluorescein staining in any location, while nasal breakup point was more frequent in those who did not present any corneal fluorescein staining (P = .045). Conclusion The location of the FTBUP in SSDE patients had specific characteristics. However, the diagnostic potential of FTBUP in early recognition of SSDE needs further validation.

scholarly journals Analysis on the First Tear Film Break-up Point in Sjögren's Syndrome and non-Sjögren's Syndrome Dry Eye Patients

2020 ◽  
Author(s):  
Songjiao Zhao ◽  
Qihua Le
Keyword(s):  
Sjögren’S Syndrome ◽  
Dry Eye ◽  
Ocular Surface ◽  
Sjögren's Syndrome ◽  
Tear Film ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Fluorescein Staining ◽  
Break Up ◽  
Sjögren‘S Syndrome

Abstract Background：Tear film instability plays an important role in the course of Sjögren's Syndrome dry eye (SSDE) even though it is generally classified as aqueous-deficient dry eye. The measurement of the first tear film break-up point (FTBUP) helps to evaluate the most unstable position of the tear film on ocular surface. We aim to investigate the first tear film break-up point (FTBUP) in Sjögren's Syndrome dry eye (SSDE) and non-Sjögren's Syndrome dry eye (NSSDE) patients, and explore its correlation with dry eye indices.Methods: Twenty-two SSDE patients (44 eyes) and 22 NSSDE patients (44 eyes) were enrolled in the study. Oculus Keratograph K5M was used to measure the FTBUP, the first and average non-invasive keratographic breakup time (f-NIKBUT and av-NIKBUT), and meibomian gland dropout. Other tests of tear film were also performed including Ocular Surface Dryness Index (OSDI), Schirmer I test, fluorescein break-up time and corneal fluorescein staining. One-way ANOVA with Bonferroni adjustment was used to compare dry eye indices. The locations of the FTBUP were compared between SSDE and NSSDE patients using chi-square test. The correlations between the FTBUP and ocular symptoms and signs were investigated using Pearson’s correlation coefficient test.Results: The FTBUP occurred at the supranasal quadrant in 12/88 eyes, supratemporal quadrant in 8/88 eyes, inferonasal quadrant in 34/88 eyes, and inferotemporal quadrant in 34/88 eyes. The percentage of the FTBUPs occurring at the inferior cornea was significantly higher in the SSDE group than in the NSSDE group (86.3% vs 68.1%, P=.042). Moreover, FTBUP was more frequently observed in the temporal area in SSDE patients with positive corneal fluorescein staining, as opposed to the nasal area in SSDE patients with negative corneal staining(P=.032). Conclusion: Tear film was more unstable in the inferior cornea than other areas of cornea in both SSDE and NSSDE patients. The location of the FTBUP in SSDE patients had a close relationship with cornea fluorescein staining.

Measuring the Lacunar Sulci as a New Indicator of Shrinkage of the Ocular Surface

2001 ◽  
Vol 11 (3) ◽  
pp. 227-232 ◽  
Author(s):  
J. Murube ◽  
L. Chenzhuo ◽  
E. Murube ◽  
L. Rivas ◽  
O. Shalaby
Keyword(s):  
Sjögren’S Syndrome ◽  
Ocular Surface ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Vanishing Point ◽  
Cicatricial Pemphigoid ◽  
Ocular Cicatricial Pemphigoid ◽  
Healthy Persons ◽  
Sjögren‘S Syndrome

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.

scholarly journals Sjögren’s Syndrome-Like Ocular Surface Disease in Thrombospondin-1 Deficient Mice

2009 ◽  
Vol 175 (3) ◽  
pp. 1136-1147 ◽  
Author(s):  
Bruce Turpie ◽  
Takeru Yoshimura ◽  
Abha Gulati ◽  
Jose David Rios ◽  
Darlene A. Dartt ◽  
...  
Keyword(s):  
Sjögren’S Syndrome ◽  
Ocular Surface ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Ocular Surface Disease ◽  
Thrombospondin 1 ◽  
Deficient Mice ◽  
Sjögren‘S Syndrome

scholarly journals Modulation of Conjunctival Goblet Cell Function by Inflammatory Cytokines

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
L. Contreras-Ruiz ◽  
A. Ghosh-Mitra ◽  
M. A. Shatos ◽  
D. A. Dartt ◽  
S. Masli
Keyword(s):  
Sjögren’S Syndrome ◽  
Inflammatory Cytokines ◽  
Goblet Cell ◽  
Ocular Surface ◽  
Cell Function ◽  
Sjögren's Syndrome ◽  
Goblet Cells ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Sjögren‘S Syndrome

Ocular surface inflammation associated with Sjögren’s syndrome is characterized by a loss of secretory function and alteration in numbers of mucin secreting goblet cells. Such changes are a prominent feature of ocular surface inflammatory diseases and are attributed to inflammation; however, the exact effect of the inflammatory cytokines on conjunctival goblet cell function remains largely unknown. In this study, we developed a primary culture of mouse goblet cells from conjunctival tissue and evaluated the effects on their function by inflammatory cytokines detected in the conjunctiva of mouse model of Sjögren’s syndrome (Thrombospondin-1 deficient mice). We found that apoptosis of goblet cells was primarily induced by TNF-αand IFN-γ. These two cytokines also inhibited mucin secretion by goblet cells in response to cholinergic stimulation, whereas IL-6 enhanced such secretion. No changes in secretory response were detected in the presence of IL-13 or IL-17. Goblet cells proliferated to varying degrees in response to all the tested cytokines with the greatest response to IL-13 followed by IL-6. Our results therefore reveal that inflammatory cytokines expressed in the conjunctiva during an ocular surface disease directly disrupt conjunctival goblet cell functions, compromising the protective function of tears, thereby contributing to ocular surface damage.

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