Management of ocular surface inflammation in Sjogren syndrome

Purpose: To evaluate the clinical efficacy of anti-inflammatory therapy in the management of primary Sjogren syndrome. Methods: Thirty-eight patients with primary Sjogren syndrome were included in this study. The diagnosis of Sjogren syndrome was made on the basis of the classification criteria of the American-European Consensus Group. Fluorescein staining score, rose-bengal staining score, Schirmer test score, tear film breakup time, and functional parameters including ocular surface disease index (OSDI) and visual analog scale (VAS) score were measured at the first visit. Anti-inflammatory therapy included topical corticosteroids, topical autologous serum, and topical cyclosporin A. The clinical efficacy of anti-inflammatory treatment was evaluated in terms of subjective symptorns and objective signs (including Schirmer-1 test, breakup time, rose-bengal score, and fluorescein score). Results: Patients with Sjogren syndrome had higher rose-bengal scores than patients with non-Sjogren dry eye (P < 0.05). The OSDI score showed better correlation with fluorescein score than with VAS score. Subjective symptoms improved with anti-inflammatory treatment in 70% of patients with primary Sjogren syndrome. Antiinflammatory treatment provided significant improvement in visual acuity and fluorescein score but did not affect Schinner score, tear breakup time, or rose-bengal score. Conclusions: Anti-inflammatory therapy in primary Sjogren syndrome significantly improved subjective symptoms and objective ocular signs; however, we did not find evidence that anti-inflammatory treatment increases tear production in patients with Sjogren syndrome.