Skip to main content
PMC home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1997 Jun;81(6):435–438. doi: 10.1136/bjo.81.6.435

Long term course of tear gland function in patients with keratoconjunctivitis sicca and Sjögren's syndrome

A Kruize 1, O P van Bijsterveld 1, R Hene 1, P C M de Wilde 1, T Feltkamp 1, L Kater 1, J Bijlsma 1
PMCID: PMC1722233  PMID: 9274404

Abstract

AIMS—To assess the course of tear gland function of patients with keratoconjunctivitis sicca (KCS) associated with primary (KCS-PSS) or secondary Sjögren's syndrome (KCS-SSS), and of patients with KCS not related to Sjögren's syndrome (KCS-NS).
METHODS—In 106 patients with dry eye an ophthalmic diagnosis of KCS was made. Subsequent evaluations revealed a diagnosis of KCS-PSS in 31, KCS-SSS in 19, and KCS-NS in 56 patients. Follow up assessments have been performed 10-12 years after initial diagnosis.
RESULTS—At baseline and at follow up tear gland function tests were worse in patients with KCS-PSS compared with the other forms of KCS. At follow up in the KCS-SSS patient group the tear gland function variables returned to marginal normal limits. In contrast with expectation, a marked improvement of the tear gland function variables in the KCS-NS patient group was noted.
CONCLUSIONS—In KCS-PSS patients tear gland function is characterised by a steady state situation. In KCS-SSS patients the normalisation of tear gland function variables most probably reflects a remission of the underlying disease. In view of the overall improvement in KCS-NS patients the term age related KCS should be avoided.



Full Text

The Full Text of this article is available as a PDF (105.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abdel-Khalek L. M., Williamson J., Lee W. R. Morphological changes in the human conjunctival epithelium. I. In the normal elderly population. Br J Ophthalmol. 1978 Nov;62(11):792–799. doi: 10.1136/bjo.62.11.792. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Abdel-Khalek L. M., Williamson J., Lee W. R. Morphological changes in the human conjunctival epithelium. II. In keratoconjunctivitis sicca. Br J Ophthalmol. 1978 Nov;62(11):800–806. doi: 10.1136/bjo.62.11.800. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Boersma H. G., van Bijsterveld O. P. The lactoferrin test for the diagnosis of keratoconjunctivitis sicca in clinical practice. Ann Ophthalmol. 1987 Apr;19(4):152–154. [PubMed] [Google Scholar]
  4. Chomette G., Auriol M., Liotet S. Ultrastructural study of the lacrimal gland in a case of Sjögren's syndrome. Scand J Rheumatol Suppl. 1986;61:71–75. [PubMed] [Google Scholar]
  5. De Wilde P. C., Baak J. P., van Houwelingen J. C., Kater L., Slootweg P. J. Morphometric study of histological changes in sublabial salivary glands due to aging process. J Clin Pathol. 1986 Apr;39(4):406–417. doi: 10.1136/jcp.39.4.406. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Fox R. I., Robinson C. A., Curd J. G., Kozin F., Howell F. V. Sjögren's syndrome. Proposed criteria for classification. Arthritis Rheum. 1986 May;29(5):577–585. doi: 10.1002/art.1780290501. [DOI] [PubMed] [Google Scholar]
  7. Gillette T. E., Allansmith M. R., Greiner J. V., Janusz M. Histologic and immunohistologic comparison of main and accessory lacrimal tissue. Am J Ophthalmol. 1980 May;89(5):724–730. doi: 10.1016/0002-9394(80)90295-0. [DOI] [PubMed] [Google Scholar]
  8. Janssen P. T., van Bijsterveld O. P. A simple test for lacrimal gland function: a tear lactoferrin assay by radial immunodiffusion. Graefes Arch Clin Exp Ophthalmol. 1983;220(4):171–174. doi: 10.1007/BF02186663. [DOI] [PubMed] [Google Scholar]
  9. Janssen P. T., van Bijsterveld O. P. Origin and biosynthesis of human tear fluid proteins. Invest Ophthalmol Vis Sci. 1983 May;24(5):623–630. [PubMed] [Google Scholar]
  10. Kassan S. S., Thomas T. L., Moutsopoulos H. M., Hoover R., Kimberly R. P., Budman D. R., Costa J., Decker J. L., Chused T. M. Increased risk of lymphoma in sicca syndrome. Ann Intern Med. 1978 Dec;89(6):888–892. doi: 10.7326/0003-4819-89-6-888. [DOI] [PubMed] [Google Scholar]
  11. Kater L., de Wilde P. C. New developments in Sjögren's syndrome. Curr Opin Rheumatol. 1992 Oct;4(5):657–665. [PubMed] [Google Scholar]
  12. Klaassen-Broekema N., Mackor A. J., van Bijsterveld O. P. The diagnostic power of the tests for tear gland related keratoconjunctivitis sicca. Neth J Med. 1992 Apr;40(3-4):113–116. [PubMed] [Google Scholar]
  13. Kruize A. A., Hené R. J., van der Heide A., Bodeutsch C., de Wilde P. C., van Bijsterveld O. P., de Jong J., Feltkamp T. E., Kater L., Bijlsma J. W. Long-term followup of patients with Sjögren's syndrome. Arthritis Rheum. 1996 Feb;39(2):297–303. doi: 10.1002/art.1780390219. [DOI] [PubMed] [Google Scholar]
  14. Kruize A. A., Smeenk R. J., Kater L. Diagnostic criteria and immunopathogenesis of Sjögren's syndrome: implications for therapy. Immunol Today. 1995 Dec;16(12):557–559. doi: 10.1016/0167-5699(95)80075-1. [DOI] [PubMed] [Google Scholar]
  15. Scott J. A morphometric study of age changes in the histology of the ducts of human submandibular salivary glands. Arch Oral Biol. 1977;22(4):243–249. doi: 10.1016/0003-9969(77)90109-1. [DOI] [PubMed] [Google Scholar]
  16. TALAL N., BUNIM J. J. THE DEVELOPMENT OF MALIGNANT LYMPHOMA IN THE COURSE OF SJOEGREN'S SYNDROME. Am J Med. 1964 Apr;36:529–540. doi: 10.1016/0002-9343(64)90101-9. [DOI] [PubMed] [Google Scholar]
  17. Van Bijsterveld O. P. Diagnosis and differential diagnosis of keratoconjunctivitis sicca associated with tear gland degeneration. Clin Exp Rheumatol. 1990 Jul-Aug;8 (Suppl 5):3–6. [PubMed] [Google Scholar]
  18. Williamson J., Gibson A. A., Wilson T., Forrester J. V., Whaley K., Dick W. C. Histology of the lacrimal gland in keratoconjunctivitis sicca. Br J Ophthalmol. 1973 Nov;57(11):852–858. doi: 10.1136/bjo.57.11.852. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. van Bijsterveld O. P. Diagnostic tests in the Sicca syndrome. Arch Ophthalmol. 1969 Jul;82(1):10–14. doi: 10.1001/archopht.1969.00990020012003. [DOI] [PubMed] [Google Scholar]
  20. van Bijsterveld O. P., Mackor A. J. Sjögren's syndrome and tear function parameters. Clin Exp Rheumatol. 1989 Mar-Apr;7(2):151–154. [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES