Relationship between clinical parameters and quality of life in primary Sjögren’s Syndrome: a prospective study

Abstract

Objectives To quantify the impact of dry eye disease (DED) on health and vision related quality of life (HR-QOL, VR-QOL) in patients with Primary Sjögren’s Syndrome (pSS). Methods Thirty-four participants with a confirmed diagnosis of pSS as per the 2016 ACR EULAR criteria participated. Main outcome measures included ocular surface parameters and HR-QOL and VR-QOL questionnaires. Clinical examination included visual acuity, Schirmer I testing, ocular surface staining (OSS) and measurement of tear film breakup time. The questionnaires included Ocular Surface Disease Index, National Eye Institute Visual Function Questionnaire-25, Short Form-36 (SF-36) and EULAR Sjogren’s Syndrome Patient Reported Index. Results Despite the majority of participants (28 female, 6 male, mean age 61.3 years) having attained LogMAR 0.3 or better visual acuity, participants scored low on VR-QOL measures, representing DED related fluctuation in functional vision. All participants suffered from moderate to severe DED. OSS did not correlate with DED symptoms or QOL parameters. Lubricant usage and symptom severity had a statistically moderate to strong negative correlation with VR-QOL and HR-QOL. This was most evident in relation to physical and physiological wellbeing. Compared with normative data, participants had a lower HR-QOL in all scales of the SF-36 ((MD = 9.91 ± 5.16); t(7) = 5.43, p = 0.001). Conclusions Participants with pSS have a lower perceived QOL especially in relation to physical and mental wellbeing, correlating to severity of DED symptoms and treatment burden. Clinical signs do not align with symptoms. Therefore, clinicians should remain cognisant, adjusting treatment in accordance with patient reported perceptions.

The Spectrum of Extraglandular Manifestations in Primary Sjögren’s Syndrome

“…During disease progression, most pSS patients will develop EGMs [ 12 ]. The severity and type of symptoms can vary widely from one patient to another and can significantly impact their quality of life [ 67 ]. The effective management of EGMs implies an early diagnosis, if possible before their clinical expression by means of predictive biomarkers, efficient and accurate investigation tools and scores, as well as personalized treatments, aiming to prevent complications and improve the patient’s quality of life.…”

Diagnostic Performance of the Tear Meniscus Osmolarity Measurement for Dry Eye Disease in Rheumatoid Arthritis Patients

“…DED can significantly impair quality of life in affected patients particularly in clinically severe disease or in symptomatic patients [ 4 ]. DED can impact visual function, general health status, and productivity [ 5 ]; also, as disease severity increases, the perceived quality of life is worse, especially in relation to mental well-being [ 6 ]. According to the last international consensus on dry eye disease from the Tear Film and Ocular Surface Society (TFOS) Second Dry Eye Workshop (DEWS II), DED is defined as a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles [ 7 ].…”