Abd-Allah Nashwa M, Hassan Amal Aly, Omar Gihan, Hamdy Mona, Abdelaziz Sahar Torky A, Abd El Hamid Waleed Mahmoud, Moussa Rabab A
Rheumatology and Rehabilitation Department, Faculty of Medicine, Minia University, Minia, Egypt.
Ophthalmology Department, Faculty of Medicine, Minia University, Minia, Egypt.
Clin Ophthalmol. 2019 Sep 11;13:1787-1797. doi: 10.2147/OPTH.S217433. eCollection 2019.
To assess the frequency of Sjӧgren's syndrome (SS), either primary or secondary to rheumatic disease, in a cohort of patients with aqueous-deficient dry eye and to determine the most accurate objective test for diagnosis of SS.
A total of 111 patients with dry eye were recruited from Minia University's Ophthalmology Outpatient Clinic (69 patients) and Rheumatology Outpatient Clinic (42 patients). The patients were screened for aqueous tear-deficient dry eye by abnormal test results of Schirmer test I (<10 mm) and tear-film break-up time (<10 seconds) in at least one eye. The diagnosis of SS was made according to the 2012 American College of Rheumatology criteria. A complete work up for SS was performed, including clinical examination, serological tests, ocular tests, and labial salivary-gland biopsy (LSGB).
Of the 111 patients, 58 had aqueous-deficient dry eye: 23 in the ophthalmology clinic cohort (group I) and 35 in the rheumatology clinic cohort (group II). Three patients had pSS, and its frequency was 13% in group I and 5.2% among all studied patients. The ocular staining score is the most diagnostic ocular test (sensitivity 100% and specificity 90.9%). Anti-SSA/Ro antibody is the most accurate serological method (sensitivity 33.3% and specificity 100%). LSGB histopathology is the most diagnostic method for SS, with sensitivity, specificity, and positive and negative predictive values of 100%.
SS was detected with reasonable frequency among dry-eye patients, particularly pSS. Screening of dry eye for SS can select SS patients early in the disease course.
评估一组水液缺乏型干眼症患者中原发性或继发于风湿性疾病的干燥综合征（SS）的发生率，并确定诊断SS最准确的客观检查方法。
从米尼亚大学眼科门诊（69例患者）和风湿病门诊（42例患者）招募了111例干眼症患者。通过至少一只眼的泪液分泌试验I（<10毫米）和泪膜破裂时间（<10秒）的异常检测结果筛选水液缺乏型干眼症患者。根据2012年美国风湿病学会标准进行SS诊断。对SS进行了全面检查，包括临床检查、血清学检查、眼部检查和唇腺活检（LSGB）。
111例患者中，58例患有水液缺乏型干眼症：眼科门诊队列中有23例（I组），风湿病门诊队列中有35例（II组）。3例患者患有原发性干燥综合征（pSS），其发生率在I组中为13%，在所有研究患者中为5.2%。眼部染色评分是最具诊断性的眼部检查（敏感性100%，特异性90.9%）。抗SSA/Ro抗体是最准确的血清学方法（敏感性33.3%，特异性100%）。LSGB组织病理学是SS最具诊断性的方法，敏感性、特异性以及阳性和阴性预测值均为100%。
在干眼症患者中，尤其是pSS患者中，SS的检出率较高。对干眼症患者进行SS筛查可在疾病早期筛选出SS患者。
