Eyeworld

EW MEETING REPORTER 132 September 2015 Reporting from the Women in Ophthalmology 2015 Summer Symposium, August 6–9, Scottsdale, Ariz. Reporting from the Women in Ophthalmology 2015 Summer Symposium Sjögren's syndrome often goes undetected, can have serious consequences The autoimmune disease Sjögren's syndrome often goes undiagnosed, which can lead to serious and sys- temic health effects, Esen K. Akpek, MD, Baltimore, told attendees at the Women in Ophthalmology 2015 Summer Symposium at the Omni Montelucia Resort in Scottsdale, Ariz. Diseases like rheumatoid ar- thritis (RA) are better known, with 1.3 million patients in the U.S., Dr. Akpek said. However, Sjögren's is believed to have 4 million patients in the U.S., a good chunk of whom are undiagnosed. The disease is much more com- mon in women; when it occurs in men, it can be even more challeng- ing to diagnose and treat. Ophthalmologists may assume that rheumatologists or primary care specialists will be the ones to diagnose Sjögren's, but surprisingly, it's often eyecare providers who de- tect it, she said. That's because these patients often present with aqueous deficient and evaporative dry eye. Another hallmark symptom of Sjögren's is dry mouth. "You can feel that their mouths are dry. They usu- ally come in with a bottle of water," Dr. Akpek said. About 50% of patients have Sjögren's that is secondary to RA or lupus. Thirty to 70% of the time, these patients will go on to have systemic effects, which can include heart and lung problems. More serious eye problems can include uveitis, retinitis, and neuritis, Dr. Akpek said. Look for symptoms and signs of dry eye through tests such as staining and a minor salivary gland biopsy. If Sjögren's is caught within 4 years of onset, clinicians can lower the risk for systemic complications. Treatment includes hydroxychloro- quine, a long-standing option that Dr. Akpek uses with all Sjögren's patients, as well as newer therapies including rituximab. These are in addition to traditional dry eye thera- pies to improve the ocular surface. "As ophthalmologists, we can diagnose these patients earlier and treat them appropriately," she said. Treatment options for glaucoma patients undergo recent evolution Although much in eye surgery has changed since the 1970s, glaucoma surgery hasn't experienced much evolution until recently, said Sameh Mosaed, MD, Irvine, Calif. "We continue to perform trab- eculectomy despite its side effects," she said. These can include blebitis, endophthalmitis, and hypotony. In addition, the surgery's effect has a finite lifespan. This is why clinicians are eager to explore more recent options for glaucoma treatment, including the SOLX Gold Shunt (SOLX, Waltham, Mass.), the CyPass Micro-Stent (Transcend Medical, Menlo Park, Calif.), and the iStent Supra (Glau- kos, Laguna Hills, Calif.), Dr. Mosaed said. All of these are currently in U.S. Food and Drug Administration clinical trials. The Women in Ophthalmology 2015 Summer Symposium was held at the Omni Montelucia Resort in Scottsdale, Ariz.

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