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Evaluation of dry eye signs and symptoms in patients with systemic sclerosis

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Abstract

Background

One of the most frequent ocular features of systemic sclerosis (SSc) is dry eye disease (DED), which has been identified to occur in 37–79% of patients. Although several studies have found weak or no correlations between symptoms and signs of dry eye, symptoms are often the motivation for seeking eye care, and are therefore a critical outcome measure when assessing treatment effect. The aim of this study is to evaluate the impact of symptoms of dry eye on vision-related quality of life in patients with systemic sclerosis, and to investigate the relation between clinical tests and symptoms of dry eye in these patients.

Methods

In this cross-sectional study, 45 consecutive patients with SSc were enrolled. For evaluation of the symptoms the “Ocular Surface Disease Index (OSDI)” questionnaire was applied to all patients. After that, all individuals were submitted to a full ophthalmic examination, including the following tests: tear break-up time, Schirmer I, rose bengal staining. Patients were then grouped into dry eye and non-dry eye groups with regard to the diagnosis of dry eye. Mann–Whitney test was used to compare continuous variables, whereas the Fisher exact test was used to compare categorical data between groups. Spearman’s correlation test was used to analyze the correlations between clinical tests and OSDI scores. P values <0.05 were considered significant.

Results

Dry eye disease was diagnosed in 22 patients (48.9%). Other ocular surface abnormalities found were: blepharitis (40% of the patients), pterygium (15.6%), pinguecula (82.2%), and superficial punctate keratitis (26.7%). Among the 45 patients, 29 patients (64.4%) had symptoms of ocular surface disease. The mean OSDI score was 26.8 ± 25.8 (SD). There were no statistically significant differences in OSDI scores between DED and non-DED patients. No substantive correlations were found between OSDI scores and TBUT, Schirmer I, or rose bengal staining score, and none of the observed correlations reached statistical significance.

Conclusion

Symptoms of dry eye have a moderate impact on vision-related quality of life in patients with systemic sclerosis and do not correlate well with clinical findings.

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Acknowledgment

Financial support: The authors would like to acknowledge FAPERJ (process # E-26/100.779/2009) for financial support of this work.

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Authors and Affiliations

  1. Department of Ophthalmology, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil

    Beatriz de A. F. Gomes & Haroldo V. Moraes Jr.

  2. Cole Eye Institute, Cleveland Clinic, 1700 E 13th st, Ap 15W, Cleveland, OH, USA, Zip code 44114

    Marcony R. Santhiago

  3. Department of Rheumatology, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil

    Mário N. L. de Azevedo

Authors
  1. Beatriz de A. F. Gomes
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  2. Marcony R. Santhiago
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  3. Mário N. L. de Azevedo
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  4. Haroldo V. Moraes Jr.
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Corresponding author

Correspondence to Marcony R. Santhiago.

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The funding organization had no role in the design or conduct of this research.

There are no conflicts of interest. The authors have no financial or proprietary interest in a product, method, or material mentioned herein.

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de A. F. Gomes, B., Santhiago, M.R., de Azevedo, M.N.L. et al. Evaluation of dry eye signs and symptoms in patients with systemic sclerosis. Graefes Arch Clin Exp Ophthalmol 250, 1051–1056 (2012). https://doi.org/10.1007/s00417-012-1938-3

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  • DOI: https://doi.org/10.1007/s00417-012-1938-3

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