الفهرس 
Introduction
Chapter I: Dry Eye DiseaseOnly 14 pages are availabe for public view
 |  | from | 196 |  |  |
| | | from | 196 | | |
Abstract
Purpose: To assess the frequency of Sjӧgren’s syndrome (SS) either primary or secondary to rheumatic disease in a cohort of patient with aqueous deficient dry eye and to determine the most accurate objective test for diagnosis of SS.
Patients and methods: 111 patients with dry eye were recruited from Ophthalmology Outpatient Clinic (69 patients) and Rheumatology Outpatient Clinic (42 patients). The patients were screened for aqueous tear deficient dry eye by abnormal test results of Schirmer test I (< 10mm) and tear film break up time (TBUT) (< 10 seconds) in at least one eye. The diagnosis of SS was made according to the 2012 American College of Rheumatology criteria (ACR). A complete work up for SS was performed including clinical examination, serological tests, ocular tests and labial salivary gland biopsy (LSGB).
Results: Of the 111 patients, 58 patients had aqueous deficient dry eye; 23 Ophthalmology Clinic Cohort (group I) and 35 Rheumatology Clinic Cohort (group II). Three patients had primary SS and its frequency was 13% among group I and 5.2% among all studied patients. Ocular staining score (OSS) is the most diagnostic ocular test (sensitivity 100% and specificity 90.9%). Anti SSA/Ro antibody is the most accurate serological method (sensitivity 33.3% and specificity 100%). Histopathology of LSGB is the most diagnostic method for SS that has sensitivity, specificity, positive and negative predictive values of 100%.
Conclusion: Sjӧgren’s syndrome was detected in a reasonable frequency among dry eye patients particularly primary SS. Screening of dry eye for SS can pick patients of SS early in disease course.