EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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E W CORNEA 1 07 Paving the way for n ovel treatment A confirmed diagnosis adds dimen- sion to eyecare. Once a patient is diagnosed with Sjogren's syndrome, eyecare professionals, in addition to treating ocular signs and symptoms, c an suggest further evaluation and potential treatment by referring the patient to a rheumatologist. Similar to cancer, an early diagnosis of Sjo- gren's syndrome may increase the chances of using treatment to pre- vent progression and ensures that other systemic findings from SS are not missed. In the same way that a m ammogram detects breast cancer when the findings are subtle and more easily treatable as opposed to advanced and terminal, the panel test may detect Sjogren's syndrome when it is in its early stages. It is my hope that early diagnosis of Sjo- gren's syndrome will lead to clinical trials developing treatments that im- pact the progression of the disease. Emerging therapies for Sjogren's syndrome have incorporated B-cell targeted therapy and monoclonal antibodies that are used in rheuma- toid arthritis, T-cell targeted therapy, and tumor necrosis inhibitors of cy- tokines. Dry eye patients and Sjogren's syndrome patients often feel that the root cause of their problem is being ignored. It is important for us to un- derstand, from their point of view, that they are experiencing chronic symptoms affecting their quality of life. Eyecare professionals are some- what aware of the correlation be- tween Sjogren's syndrome and dry eye, but it is time for us to consider ourselves in the frontline for identi- fying this disease. We have an oppor- tunity to impact patients' lives in a positive way beyond providing care for their ocular problems. EW References 1. About Sjögren's Syndrome. Sjögren's Syn- drome Foundation website. www.sjogrens.org. Accessed November 11, 2013. 2. Nezos A, Papageorgiou A, Fragoulis G, et al. B-cell activating factor genetic variants in lymphomagenesis associated with primary Sjogren's syndrome. J Autoimmun. Published July 8, 2013. Accessed November 18, 2013. 3. Akpek E, Klimava A, Thorne JE, et al. Evaluation of Patients with Dry Eye for Presence of Underlying Sjogren's Syndrome. Cornea 2009;28:493-497. 4. Shmerling RH, Delbanco TL. How useful is the rheumatoid factor? An analysis of sensitiv- i ty, specificity, and predictive value. Arch Intern Med 1992;152:2417-2420. 5. Langford C. Clinical features and diagnosis of small-vessel vasculitis. Cleveland Clinic Journal of Medicine 2012;79:S3-S7. Editors' note: Dr. Asbell is a professor in the Department of Ophthalmology a nd director of the cornea service and Refractive Surgery Center, Icahn School of Medicine at Mount Sinai, New York. Dr. Asbell has financial interests with Nicox. C ontact information Asbell: penny.asbell@mssm.edu March 2014 88-107 Cornea_EW March 2014-DL2_Layout 1 3/6/14 3:47 PM Page 107