Sjögren Disease and the Corneal Surface

Area of Science:

• Ophthalmology
• Neuroscience
• Immunology

Background:

• Sjögren disease causes dry eye via lacrimal gland dysfunction, leading to reduced tear secretion and ocular surface damage.
• Corneal nerves are critical in Sjögren disease, with abnormalities influencing patient symptoms.
• Two distinct phenotypes exist: neurotrophic (reduced symptoms despite signs) and neuropathic (disproportionate symptoms).

Purpose of the Study:

• To explore the role of corneal nerve status in Sjögren disease.
• To differentiate between neurotrophic and neuropathic aspects of dry eye in Sjögren disease.
• To highlight the potential for personalized treatment based on corneal nerve evaluation.

Main Methods:

• Clinical assessment of ocular surface signs.
• Evaluation of corneal nerve structure and function.
• Symptom analysis including pain and sensitivity.

Main Results:

• Patients with Sjögren disease display varied corneal nerve abnormalities.
• Distinct symptom profiles correlate with specific nerve phenotypes (neurotrophic vs. neuropathic).
• Clinical signs may not always align with reported symptoms, particularly in the neurotrophic type.

Conclusions:

• Corneal nerve status is a key factor in the presentation of dry eye in Sjögren disease.
• Identifying neurotrophic and neuropathic phenotypes is crucial for understanding patient experience.
• Comprehensive assessment of corneal nerves can guide personalized therapeutic strategies for Sjögren disease patients.