Assessment of Inflammatory and Functional Changes in the Ocular Surface Associated With Dry Eye Disease
Condition: Sjogren's Syndrome; Dry Eye
MeSH terms: Sjogren's Syndrome; Dry Eye Syndromes; Keratoconjunctivitis Sicca; Eye Diseases
Study type: Observational

Summary: 
      This project will examine the similarities and differences of the ocular surface and tear
      film in patients with Sjogren's syndrome related to dry eye, severe dry eye and those who do
      not have dry eye. This knowledge will help clinicians understand the processes that create
      these dry eye conditions and will strengthen the treatment and management strategies that
      will be used. The subjects will participate in a series of dry eye tests that they have
      already experienced in clinic, along with the gathering of tear samples and surface cells.
      These tissues will then be analyzed at a distant site.
    

Detailed description: 
      Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms
      of discomfort, visual disturbance and tear film instability with potential damage to the
      ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation
      of the ocular surface. A number of factors have been implicated in triggering this disease,
      including age, hormone changes and autoimmune disease.

      Sjogren's syndrome(SS) is a common autoimmune disorder, characterized by chronic inflammatory
      infiltration of exocrine glands (particularly salivary and lacrimal) and systemic immune
      reactivity, resulting in dry eye and dry mouth. The mechanism of inflammation of the lacrimal
      gland in these patients is well documented. It is believed that these pathological changes
      facilitate the secretion of inflammatory biochemicals on to the ocular surface. Additionally,
      in SS, there are also pathological changes to epithelial cells of the cornea and conjunctiva
      (such as upregulation of mRNAs coding for inflammatory cytokines) which subsequently
      contribute to the increased secretion of the cytokines themselves. Taken together, these
      changes result in an increased concentration of inflammatory mediators in the tear film,
      which then drive the propagation of the dry eye disease process. Severe dry eye (DE) patients
      present with a very similar clinical outcome to SS patients, however, inflammatory processes
      associated with either the initiation or propagation of their dry eye disease has not been
      well characterized.

      This research project was established to quantify similarities and / or differences between
      SS and severe dry eye participants, with respect to ocular surface inflammation and function.
      Specifically, this study will examine dry eye symptoms, ocular surface integrity and tear
      film volume and flow. Additionally, the concentration of inflammatory cytokines present in
      the tear film will be quantified.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Primary care
      
Keywords: Non dry eyed(normals)