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Ophthalmology. 2015 Jan;122(1):56-61. doi: 10.1016/j.ophtha.2014.07.026. Epub 2014 Aug 30.

Ocular and systemic morbidity in a longitudinal cohort of Sjögren's syndrome.

Author information

1
Ocular Surface Diseases and Dry Eye Clinic, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Jerome L. Greene Sjögren's Syndrome Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: esakpek@jhmi.edu.
2
Ocular Surface Diseases and Dry Eye Clinic, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
3
Jerome L. Greene Sjögren's Syndrome Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

Abstract

PURPOSE:

To report vision-threatening ocular manifestations of primary Sjögren's syndrome (SS).

DESIGN:

Retrospective review.

PARTICIPANTS:

Consecutive patients evaluated at an SS center between January 2007 and May 2011.

METHODS:

Data collection was completed in March 2013. The 2002 American-European consensus criteria were used for diagnosis of SS.

MAIN OUTCOME MEASURES:

Frequency of extraglandular ocular findings and timing of their diagnosis relative to that of SS and dry eye were assessed.

RESULTS:

One hundred sixty-three patients were included. Almost all patients (98%) had a history of dry eye for an average of 10.4 years (median, 7.9 years) before presentation. One or more extraglandular ocular manifestations were present in 40 patients (25%), and vision-threatening findings were present in 22 patients (13%). Twelve patients (55%) with a vision-threatening ocular finding did not have a diagnosis of SS at presentation. Sixty-eight patients (42%) had extraglandular systemic manifestations of SS. Patients with vision-threatening ocular findings were 3.9 times more likely to have systemic involvement (95% confidence interval, 1.4-11.0; P = 0.010). Peripheral neuropathy, interstitial nephritis, and vasculitis were more common in those with vision-threatening ocular findings compared with patients without (P < 0.05 for all).

CONCLUSIONS:

These results from a tertiary referral-based cohort demonstrate that primary SS frequently is associated with ocular and systemic complications. Dry eye precedes these findings on average by 1 decade. Therefore, ophthalmologists should consider assessing for SS in patients with clinically significant dry eye.

PMID:
25178806
DOI:
10.1016/j.ophtha.2014.07.026
[Indexed for MEDLINE]

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