Ophthalmologic Manifestations of Primary Sjögren’s Syndrome

Abstract

Sjögren’s syndrome (SS) is a chronic, progressive, inflammatory, autoimmune disease, characterized by the lymphocyte infiltration of exocrine glands, especially the lacrimal and salivary, with their consequent destruction. The onset of primary SS (pSS) may remain misunderstood for several years. It usually presents with different types of severity, e.g., dry eye and dry mouth symptoms, due to early involvement of the lacrimal and salivary glands, which may be associated with parotid enlargement and dry eye; keratoconjunctivitis sicca (KCS) is its most common ocular manifestation. It is still doubtful if the extent ocular surface manifestations are secondary to lacrimal or meibomian gland involvement or to the targeting of corneal and conjunctival autoantigens. SS is the most representative cause of aqueous deficient dry eye, and the primary role of the inflammatory process was evidenced. Recent scientific progress in understanding the numerous factors involved in the pathogenesis of pSS was registered, but the exact mechanisms involved still need to be clarified. The unquestionable role of both the innate and adaptive immune system, participating actively in the induction and evolution of the disease, was recognized. The ocular surface inflammation is a central mechanism in pSS leading to the decrease of lacrimal secretion and keratoconjunctival alterations. However, there are controversies about whether the ocular surface involvement is a direct autoimmune target or secondary to the inflammatory process in the lacrimal gland. In this review, we aimed to present actual knowledge relative to the pathogenesis of the pSS, considering the role of innate immunity, adaptive immunity, and genetics.

Short-Term Effects of a Novel Eye Mask Producing Heat and Vibration for the Treatment of Meibomian Gland Dysfunction: A Pilot Study

“…In the present study, a newly-developed eye mask producing heating in the first phase of session and heating plus vibration in the second phase has been used for the treatment of patients with symptomatic MGD. Since MGD may be associated with other systemic diseases such as rosacea and Sjogren syndrome [ 21 , 22 ], a heterogeneous MGD population was enrolled to obtain results that are generalizable to the real-life clinical practice. This preliminary analysis showed that half hour after the first mask session, tear film parameters (NIBUT and LLT) improved significantly.…”

Knockdown of LncRNA SNHG1 Suppresses Corneal Angiogenesis by the Regulation of miR-195-5p/VEGF-A

“…Many studies in the past years showed that various factors can cause corneal injuries, including the inflammatory causes of neovascularization; for example, ocular mucous membrane pemphigoid (MMP) can induce an inflammatory response that leads to the formation of a fibrotic scar [ 14 ], Sjögren's syndrome can cause keratitis sicca with inflammation [ 15 ]. Moreover, ocular graft-versus-host disease affects all the structures of the entire ocular surface system, including lacrimal and meibomian glands, cornea, conjunctiva, eyelids, nasolacrimal duct, and tears [ 16 ].…”

Dry eye disease associated with Primary Sjogren syndrome: An update

“…6 The slit lamp examination reveals redness, conjunctival keratinization with chalasis, and punctate or filamentous keratitis. [41][42][43][44][45][46] Other ocular manifestations of pSS which have been reported include episcleritis/scleritis, uveitis, retinal vasculitis, cicatrizing conjunctivitis, sterile corneal ulcer/infiltration, corneal melting perforation and optic neuritis. 47…”