Systemic Conditions Associated with Severity of Dry Eye Signs and Symptoms in the Dry Eye Assessment and Management Study

Yu, Kimberley; Bunya, Vatinee Y.; Maguire, Maureen G.; Asbell, Penny A.; Ying, Gui‐Shuang; Assessment, Dry Eye

doi:10.1016/j.ophtha.2021.03.030

Cited by 57 publications

(49 citation statements)

References 66 publications

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“…This supports the fact that dry eye disease is by no means a specific characteristic of Sjögren’s syndrome, even though lymphocytic infiltration of the lacrimal glands is a known hallmark for this entity. On the contrary, sicca symptoms have been previously described in chronical diseases [ 50 , 51 ]. It is also possible that neurological involvement of corneal nerve fibres in patients with Sjögren’s syndrome precedes more severe sicca symptoms as has been shown for other neurological manifestations of Sjögren’s syndrome [ 52 , 53 ].…”

Section: Discussionmentioning

confidence: 99%

Trigeminal Nerve Affection in Patients with Neuro-Sjögren Detected by Corneal Confocal Microscopy

Seeliger

Gehlhaar

Oluwatoba-Popoola

et al. 2022

JCM

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Background: Patients with Sjögren’s syndrome and polyneuropathy more frequently develop cranial nerve affection when compared to patients with chronic inflammatory demyelinating polyneuropathy (CIDP). We therefore aimed to analyze trigeminal corneal nerve fibre characteristics in both patient groups. Methods: A total of 26 patients with Sjögren’s syndrome associated neuropathy and 29 patients with CIDP were recruited at our university hospital and compared to 6 healthy controls. Dry eye symptoms and signs were assessed via clinical examination and the Ocular Disease Surface Index questionnaire. Trigeminal corneal nerve fibres were analyzed via corneal confocal microscopy (CCM) as a non-invasive in vivo microscopy. Results: CCM revealed significantly reduced corneal nerve fibre density and corneal nerve fibre main branch density in the Neuro-Sjögren group when compared with healthy controls. There were no significant group differences between the Neuro-Sjögren and the CIDP group for any of the microscopic parameters. Dry eye assessment showed similarly reduced scores for both patient groups, while healthy controls showed better results for objective dry eye signs. There was no correlation between microscopic parameters of the corneal confocal microscopy and parameters of dry eye assessment. Conclusions: Our data revealed trigeminal corneal nerve affection in patients with neuropathy associated with Sjögren’s syndrome and patients with CIDP detected by CCM. No difference was found between both neuropathy groups indicating that CCM is not able to distinguish between both entities.

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Section: Discussionmentioning

confidence: 99%

Trigeminal Nerve Affection in Patients with Neuro-Sjögren Detected by Corneal Confocal Microscopy

Seeliger

Gehlhaar

Oluwatoba-Popoola

et al. 2022

JCM

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“…10 Regarding thyroid dysfunction, the authors suspect that, as reported in another study, 12 DED severity is related to thyroid eye disease. 10…”

Section: Epidemiologic Features Of Dry Eye Disease (Ded) In Autoimmun...mentioning

confidence: 91%

“…9 The Dry Eye Assessment and Management (DREAM) Study (clinicaltrials.gov identifier, NCT02128763) evaluated if systemic conditions known to be risk factors for DED are also associated with the severity of DED signs and symptoms. 10 Of 535 patients included, 81.1% were females, 17.6% had thyroid dysfunction, 10.7% had DM-I or II, 8.8% had RA, and 5.0% had Sjögren syndrome (SS). According to the DREAM Study, SS and RA were autoimmune diseases significantly associated with severe signs of DED.…”

Section: Epidemiologic Features Of Dry Eye Disease (Ded) In Autoimmun...mentioning

confidence: 99%

Dry eye disease, a prominent manifestation of systemic autoimmune disorders

Bustamante-Arias

Ruiz-Lozano

Rodríguez-García

2022

European Journal of Ophthalmology

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Objectives Dry eye disease (DED) is arguably the most frequent ocular disease encountered in ophthalmic clinical practice. DED is frequently an underestimated condition causing a significant impact on visual function and quality of life. Many systemic autoimmune diseases (SAIDs) are related to moderate to severe DED. The main objective of this review is to enhance the awareness among ophthalmologists of the potential association of an underlying SAID in a high-risk patient with DED. Methods An exhaustive literature search was performed in the National Library of Medicine's Pubmed, Scopus, Web of Science, and Google Scholar databases for all English language articles published until November 2021. The main keywords included “dry eye disease” associated with autoimmune, connective tissue, endocrine, gastrointestinal, hematopoietic, vascular, and pulmonary diseases. Case reports, series, letters to the editor, reviews, and original articles were included. Results Although DED is frequently associated with SAIDs, its diagnosis is commonly delayed or missed, producing significant complications, including corneal ulceration, melting, scleritis, uveitis, and optic neuritis resulting in severe complications detrimental to visual function and quality of life. SAID should be suspected in a woman, 30 to 60 years old with a family history of autoimmunity, presenting with DED symptoms and extraocular manifestations including arthralgias, dry mouth, unexplained weight and hair loss, chronic fatigue, heat or cold intolerance, insomnia, and mood disorders. Conclusions Establishing the correct diagnosis and treatment of DED associated with SAIDs is crucial to avoid its significant burden and severe ocular complications.

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“…Enrolled participants will not be restricted by age, gender or ethnic group. Exclusion criteria will include: history of ocular medication or wearing contact lenses within 3 months, history of ocular surgery within 6 months, presence of conjunctiva, cornea, tear duct, iris, meibomian gland and other ocular diseases,34 diagnosis of other systemic diseases that affect tear secretion, such as Sjögren syndrome and rheumatoid arthritis 35…”

Section: Methodsmentioning

confidence: 99%

Acupuncture for patients with type 2 diabetes mellitus with dry eye: protocol for a systematic review and meta-analysis

Wei

et al. 2022

BMJ Open

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IntroductionThe global incidence of patients with type 2 diabetes mellitus (T2DM) with dry eye is increasing annually, which imposes additional healthcare costs and financial burden on families and societies. In clinical practice, artificial tears are often used for symptomatic treatment, but these can only relieve the symptoms of discomfort. Acupuncture is a widely used alternative therapy. Indeed, randomised trials have found that acupuncture confers a definite therapeutic effect on patients with T2DM with dry eye. However, systematic reviews on the effectiveness and safety of acupuncture are lacking, therefore this systematic review aims to evaluate the effectiveness and safety of acupuncture for T2DM with dry eye.Methods and analysisFour English databases (PubMed, Cochrane Library, Embase and Ovid), three Chinese databases (China National Knowledge Infrastructure, Wanfang, Chonqing VIP Information), three Japanese databases (Japan Science, Technology Agency and Japan Medical Abstracts Society) and three Korean databases (Korean Medical database, Oriental Medicine Advanced Searching Integrated System and Research Information Service System) will be searched for reports published between 1 January 2007 and 1 October 2021. Only randomised controlled trials will be included, and language or publication dates will not be restricted. Two researchers will independently extract, manage and analyse data. The primary outcomes will include Schirmer’s I test, breakup time, corneal fluorescein staining and ocular surface disease index scores. Secondary results will include visual analogue scale scores for ocular symptoms and any adverse events related to acupuncture. We will use Review Manager V.5.4 for the meta-analysis. The risk of bias will be independently assessed using Cochrane’s ‘risk of bias’ tool.Ethics and disseminationEthical approval will not be required since raw data will not be collected or generated. Our findings will be disseminated through peer-reviewed journal.PROSPERO registration numberCRD42021271891.

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Systemic Conditions Associated with Severity of Dry Eye Signs and Symptoms in the Dry Eye Assessment and Management Study

Cited by 57 publications

References 66 publications

Trigeminal Nerve Affection in Patients with Neuro-Sjögren Detected by Corneal Confocal Microscopy

Trigeminal Nerve Affection in Patients with Neuro-Sjögren Detected by Corneal Confocal Microscopy

Dry eye disease, a prominent manifestation of systemic autoimmune disorders

Acupuncture for patients with type 2 diabetes mellitus with dry eye: protocol for a systematic review and meta-analysis

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