title: Visante optical coherence tomography and tear function test evaluation of cholinergic treatment response in patients with sjögren syndrome.
abstract: OBJECTIVE
  To evaluate tear meniscus changes in patients with Sjögren syndrome (SS) receiving oral pilocarpine with Visante optical coherence tomography (OCT).
  
  
  METHODS
  Eight patients with primary SS were recruited in this prospective interventional case series study. Patients received pilocarpine tablets twice a day for 3 months. Visual analog scale assessment for dry eye and dry mouth symptoms was carried out. Patients underwent OCT and slit-lamp microscopy graticule scale tear meniscus height (TMH) measurements, strip meniscometry testing, tear film breakup time measurement, fluorescein and Rose Bengal staining, and the Schirmer 1 test. The data were analyzed 1 week, 1 month, and 3 months after treatment. Mann-Whitney test was performed.
  
  
  RESULTS
  Visual analog scale assessment showed a significant time-wise improvement (P < 0.05). OCT and graticule scale TMH measurements significantly improved after 1 week (P < 0.05), 1 month, and 3 months of treatment (P < 0.001). Strip meniscometry, mean tear film stability, and fluorescein and Rose Bengal scores remained improved 3 months after treatment (P < 0.001), whereas Schirmer 1 test values tended to improve without statistical significance.
  
  
  CONCLUSIONS
  Visante OCT was effective in monitoring tear meniscus changes during the course of treatment noninvasively and quickly. Oral pilocarpine seemed to be effective in improving TMH, and the signs and symptoms of dryness in patients with SS.
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. osamaibrahim82@yahoo.com
authors.forename: Osama M A
authors.initials: OM
authors.lastname: Ibrahim
authors.forename: Murat
authors.initials: M
authors.lastname: Dogru
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kawashima
authors.forename: Tais H
authors.initials: TH
authors.lastname: Wakamatsu
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsubota
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujishima
mesh_terms: D000284:Administration, Oral; D000368:Aged; D005260:Female; D005456:Fluorescent Dyes; D015590:Fluorophotometry; D006801:Humans; D018721:Muscarinic Agonists / Q000627:therapeutic use*; D010862:Pilocarpine / Q000627:therapeutic use*; D011446:Prospective Studies; D012395:Rose Bengal; D012859:Sjogren's Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D013607:Tablets; D013666:Tears / Q000502:physiology*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
chemical_list: D005456:Fluorescent Dyes; D018721:Muscarinic Agonists; D013607:Tablets; D010862:Pilocarpine; D012395:Rose Bengal