engleski

Ocular involvement in dry mouth patients : value of six ophthalmologic parameters

Purpose were to assess lachrymal and salivary function in patients with Sjogren’ s syndrome (SS) and non-SS dry mouth patients ; to assess the reliability of 6 different surveys related to dry eye in SS diagnosis. Study included 66 dry mouth patients (48 patients with SS, and 18 age and sex matched non-SS sicca controls). All participants were examined: unstimulated whole saliva (UWS), stimulated whole saliva (SWS), serology testing, labial gland biopsy (LGB). Six ophthalmologic parameters were measured: subjective questionnaire Ocular Surface Disease Index (OSDI), and objective tests: Schirmer-I and Schirmer -II tests, Tear Break-up Time (TBUT) test, Rose-Bengal (RB) and Lissamine-green (LG) scores. Differences between groups were analyzed using Mann Whitney U-test ; ROC curves were calculated for each ophthalmologic parameter’ s sensitivity and specificity ; Spearman’ s coefficient assessed correlations between OSDI and objective ocular tests. Statistical differences between groups were found in UWS, SWS, OSDI and ophthalmologic tests. Most significant differences between groups were observed in RB and LG scores. Within SS group, between subjects with positive and negative LGB findings, statistically significant differences were found for ophthalmologic tests, UWS and SWS. ROC curves showed sensitivity and specificity of ocular parameters in ascending order: TBUT (0.714) OSDI (0.740), Schirmer-I (0.780), Schirmer-II (0.802), LG (0.990) and RB (1.000). Highest correlations with OSDI were observed for RB and LG cores, whereas for Schirmer-I was the lowest. Study reveals the limited reliability of TBUT and Schirmer-I, and emphasizes vital dye staining as the test of choice in the Sjogren’ s syndrome differential diagnosis.

xerostomia; xerophthalmia; Schirmer's test; salivary gland biopsy; Rose-Bengal score

DOI: 10.1111/j.1601-0825.2008.01481.x