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Conjunctival staining valuable in screening dry eye patients for Sjögren’s
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Schirmer 1 testing and conjunctival staining with lissamine green are critical tests to include when screening dry eye patients for possible Sjögren’s syndrome, according to a study in the American Journal of Ophthalmology.
The study goal was to explore the association of individual surface diagnostic tests with extraocular objective diagnostic tests for Sjögren’s syndrome, according to the study.
The researchers utilized data from the Sjögren’s International Clinical Collaborative Alliance from nine international academic sites.
The study included 3,514 participants with Sjögren’s (SS) or possible SS who received an ocular surface evaluation, including Schirmer 1 testing, tear break-up time (TBUT) and staining of the cornea and conjunctiva.
When each dry eye diagnostic test was assessed individually, the researchers found that a positive labial salivary gland (LSG) biopsy and positive anti-SSA/B serology were each significantly associated with all dry eye tests including Schirmer’s test, TBUT, corneal staining and conjunctival staining.
The odds of having a positive LSG biopsy increased by approximately 50% for each unit increase in conjunctival staining and approximately 16% for each unit increase in corneal staining, they wrote.
The odds of having a positive LSG biopsy were also significantly higher among those with an abnormal Schirmer test.
They also determined that the odds of having positive serology was significantly higher in those with an abnormal Schirmer test or conjunctival staining, but not for those with corneal staining or an abnormal TBUT.
The researchers explained how it is not economically feasible to refer all dry eye patients for SS work ups.
“While many [eye care providers] commonly use fluorescein staining of the cornea in their evaluation of dry eye patients, few routinely assess ocular surface staining of the conjunctiva,” researchers said.
Only 4.9% to 10% of eye care professionals routinely assess staining of the conjunctiva, they reported. – by Abigail Sutton
Disclosure: The researchers reported no relevant financial disclosures.
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