[Ocular surface analysis in patients affected with rheumatic diseases].
OBJECTIVE
The international criteria for primary Sjögren's Syndrome (SS I) diagnosis (Vitali et al. 2002) include the Schirmer test I and vital dye staining as tests for ocular surface involvement, but diagnosis can be reached also when the item for ocular signs is not satisfied. The purpose of our study was to evaluate the ocular surface in patients with Sjögren's Syndrome, non-Sjögren's autoimmune diseases and Sicca Syndrome, to understand whether the SS I diagnosis can be targeted also on other tests related to the ocular surface status.


METHODS
Clinical and cytological data were collected from 122 patients: 40 patients had diagnosis of Primary Sjögren's Syndrome, 51 a non Sjögren's autoimmune disease and 31 had symptoms of dry eye. A validated questionnaire on symptoms was filled by each patient; clinical tests included: Schirmer test I, Jones test, Ferning test, Break Up Time, corneal aesthesiometry, tear clearance test, vital dye staining of the ocular surface, scraping and impression conjunctival cytology. Data were statistically evaluated by using SPSS software and Mann-Whitney analysis on unpaired data.


RESULTS
Data show that the subjective symptoms score, tear production, tear turnover, corneal sensitivity and ocular surface integrity are affected in SS I patients, with a statistically significant difference when matched to the other two groups.


CONCLUSIONS
Our results suggest to enlarge the spectrum of ocular surface analysis, to support and orient a differential diagnosis among the autoimmune diseases.
Versura
P
P
Dipartimento A.Valsalva, Sezione Oftalmologia I, Scuola di Specializzazione in Reumatologia Alma Mater Studiorum, Università di Bologna, 40138 Bologna. versura@alma.unibo.it
Frigato
M
M
Bernabini
B
B
Mulè
R
R
Malavolta
N
N
Campos
E C
EC
D001172:Arthritis, Rheumatoid / Q000175:diagnosis*; D003240:Connective Tissue Diseases / Q000175:diagnosis*; D003627:Data Interpretation, Statistical; D003937:Diagnosis, Differential; D003941:Diagnostic Techniques, Ophthalmological; D015352:Dry Eye Syndromes / Q000175:diagnosis*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis*; D012595:Scleroderma, Systemic / Q000175:diagnosis*; D012859:Sjogren's Syndrome / Q000175:diagnosis*; D013499:Surface Properties; D011795:Surveys and Questionnaires; D013666:Tears / Q000378:metabolism / Q000502:physiology