Jung Hyun Ji, Jun Roo Min, Han Kyung Eun
Department of Ophthalmology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
Department of Ophthalmology, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2024 Dec;38(6):480-488. doi: 10.3341/kjo.2024.0108. Epub 2024 Oct 22.
To report the proportion of ocular involvement in primary Sjögren syndrome (pSS) and to analyze various dry eye indexes and serum titers of markers depending on whether ocular involvement has occurred or not.
This retrospective study considered 214 patients referred from the rheumatology department for pSS workup. Symptom questionnaires, ocular surface stain score (OSS), Schirmer test, tear breakup time (TBUT), meibomian gland dropout, meibum quality, meibum expressibility, lid margin abnormalities, and lipid layer thickness were evaluated. Anti-Ro, anti-La, and antinuclear antibodies, rheumatoid factor, erythrocyte sedation rate, and C-reactive protein were included as systemic serum titers of markers. Patients with (group 1) and without (group 2) ocular involvement were compared. We conducted a further subgroup analysis of group 1 by dividing it into two groups based on whether or not the cases met all the ocular criteria for pSS diagnosis.
Among the 214 referred patients, 118 were diagnosed as pSS: 87 out of 118 (73.7%) in group 1 and 31 (26.3%) in group 2. Group 1 showed higher meibum quality scores (p = 0.016), meibum expressibility (p = 0.010), and lid margin abnormalities on the lower lid (p = 0.029) and lower TBUT (p = 0.016) than group 2. OSS, TBUT, and the Schirmer test statistically differed (p < 0.001, p = 0.041, and p = 0043, respectively) between the patients who satisfied both ocular criteria (n = 46) and those who satisfied only one criterion (n = 41). There were no statistical differences in serum titers of markers between the two groups.
About half of patients referred from the rheumatology department for diagnosis of pSS were diagnosed with pSS. The proportion of ocular involvement in the pSS patients was 73.7%, and half of these patients met both ocular criteria. Only anti-Ro antibodies negatively correlated with TBUT. Also, OSS, TBUT, and Schirmer test were statistically different between the two subgroups.
报告原发性干燥综合征（pSS）眼部受累的比例，并根据是否发生眼部受累分析各种干眼指标和血清标志物滴度。
这项回顾性研究纳入了214名从风湿科转诊来进行pSS检查的患者。评估了症状问卷、眼表染色评分（OSS）、泪液分泌试验、泪膜破裂时间（TBUT）、睑板腺缺失、睑脂质量、睑脂排出能力、睑缘异常和脂质层厚度。抗Ro、抗La和抗核抗体、类风湿因子、红细胞沉降率和C反应蛋白作为全身性血清标志物滴度进行检测。比较了有眼部受累的患者（第1组）和无眼部受累的患者（第2组）。我们根据病例是否符合pSS诊断的所有眼部标准，将第1组进一步分为两组进行亚组分析。
在214名转诊患者中，118名被诊断为pSS：第1组118名中有87名（73.7%），第2组31名（26.3%）。第1组的睑脂质量评分（p = 0.016）、睑脂排出能力（p = 0.010）、下睑睑缘异常（p = 0.029）和较低的TBUT（p = 0.016）均高于第2组。在同时满足两项眼部标准的患者（n = 46）和仅满足一项标准的患者（n = 41）之间，OSS、TBUT和泪液分泌试验在统计学上存在差异（分别为p < 0.001、p = 0.041和p = 0.043）。两组之间血清标志物滴度无统计学差异。
从风湿科转诊来诊断pSS的患者中约一半被诊断为pSS。pSS患者中眼部受累的比例为73.7%，其中一半患者符合两项眼部标准。仅抗Ro抗体与TBUT呈负相关。此外，两个亚组之间的OSS、TBUT和泪液分泌试验在统计学上存在差异。
