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Published on: October 13, 2023
Longitudinal Change in Keratoconjunctivitis Sicca by Sjögren's Disease Status
Sally E Peterson1, Vinayak Prathikanti2, Fanxiu Xiong2
1Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California, USA; Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, California, USA.
American Journal of Ophthalmology
|July 26, 2026
Summary
Patients with Sjögren's disease (SjD) and dry eye (KCS) showed worse ocular surface signs and greater worsening over time compared to those with isolated KCS. This suggests KCS with SjD and isolated KCS are distinct dry eye conditions.
Area of Science:
- Ophthalmology
- Immunology
- Rheumatology
Background:
- Dry eye disease, or keratoconjunctivitis sicca (KCS), is a common condition with varying severity.
- Sjögren's disease (SjD) is an autoimmune disorder often associated with KCS, but isolated KCS also exists.
- Longitudinal comparison of ocular surface changes in these distinct patient groups is crucial for understanding disease progression.
Purpose of the Study:
- To compare longitudinal changes in ocular surface signs and symptoms over 2-3 years.
- To differentiate between isolated KCS (KCS-only) and KCS concomitant with SjD (KCS+SjD).
- To investigate if these represent distinct clinical forms of dry eye disease.
Main Methods:
- Prospective cohort study utilizing the Sjögren's International Collaborative Clinical Alliance (SICCA) registry.
- Standardized ocular surface testing (OSS, Schirmer I, TBUT, OSDI-6) at baseline and 2-3 year follow-up.
- Multivariable linear regression analyzed differences in longitudinal changes between KCS-only and KCS+SjD groups.
Main Results:
- 427 participants (305 KCS+SjD, 122 KCS-only) were analyzed.
- KCS+SjD group showed significantly more severe dry eye signs at baseline and greater longitudinal worsening.
- Worsening observed in Ocular Staining Score (OSS), Tear Break-Up Time (TBUT), and Schirmer I in KCS+SjD group; OSDI-6 showed no significant difference.
Conclusions:
- KCS+SjD patients exhibit more severe baseline ocular findings and greater longitudinal decline in objective measures compared to KCS-only patients.
- Findings support KCS associated with SjD and isolated KCS as potentially distinct clinical entities.
- This differentiation aids in classifying dry eye subtypes and understanding disease heterogeneity.
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