title: Long-term course of tear gland function in patients with keratoconjunctivitis sicca and Sjögren's syndrome.
abstract: OBJECTIVE
  To assess the course of tear gland function of patients with keratoconjunctivitis sicca (KCS) associated with primary (KCS-PSS) or secondary Sjögren's syndrome (KCS-SSS), and of patients with KCS not related to Sjögren's syndrome (KCS-NS).
  
  
  METHODS
  In 106 patients with dry eye an ophthalmic diagnosis of KCS was made. Subsequent evaluations revealed a diagnosis of KCS-PSS in 31, KCS-SS in 19, and KCS-NS in 56 patients. Follow up assessments have been performed 10-12 years after initial diagnosis.
  
  
  RESULTS
  At baseline and at follow up tear gland function tests were worse in patients with KCS-PSS compared with the other forms of KCS. At follow up in the KCS-SSS patient group the tear gland function variables returned to marginal normal limits. In contrast with expectation, a marked improvement of the tear gland function variables in the KCS-NS patient group was noted.
  
  
  CONCLUSIONS
  In KCS-PSS patients tear gland function is characterised by a steady state situation. In KCS-SSS patients the normalisation of tear gland function variables most probably reflects a remission of the underlying disease. In view of the overall improvement in KCS-NS patients the term age related KCS should be avoided.
authors.affiliation: Department of Rheumatology and Clinical Immunology, University Hospital Utrecht, Netherlands.
authors.forename: A A
authors.initials: AA
authors.lastname: Kruize
authors.forename: O P
authors.initials: OP
authors.lastname: van Bijsterveld
authors.forename: R J
authors.initials: RJ
authors.lastname: Hené
authors.forename: P C
authors.initials: PC
authors.lastname: de Wilde
authors.forename: T E
authors.initials: TE
authors.lastname: Feltkamp
authors.forename: L
authors.initials: L
authors.lastname: Kater
authors.forename: J W
authors.initials: JW
authors.lastname: Bijlsma
mesh_terms: D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007638:Keratoconjunctivitis Sicca / Q000503:physiopathology*; D007765:Lacrimal Apparatus / Q000378:metabolism*; D007781:Lactoferrin / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009113:Muramidase / Q000032:analysis; D012859:Sjogren's Syndrome / Q000503:physiopathology*; D018709:Statistics, Nonparametric; D013666:Tears / Q000737:chemistry
chemical_list: D009113:Muramidase; D007781:Lactoferrin