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Presentation, aetiology and outcomes of corneal ulceration in Sjogren’s Syndrome

Eye volume 37, pages 3217–3220 (2023)Cite this article

Subjects

Abstract

Purpose

To report the clinical course of corneal ulceration/perforation in patients with Sjogren’s syndrome.

Methods

Retrospective descriptive study of patients diagnosed with Sjogren’s syndrome (primary and secondary) and corneal ulceration over past 8 years at tertiary eye care network. Assessed parameters were demographics, clinical details, microbiological profile, types of intervention and their outcomes.

Results

Forty-six eyes of 44 patients (11 males; mean age, 50 years) had corneal ulceration (28 eyes) or perforation (18 eyes) at the time of presentation. Of 46 eyes, 38 had sterile ulceration/perforation and rest 8 showed microorganism on microscopy or culture. The location was peripheral in 63% of eyes and it was the first presenting sign of Sjogren’s syndrome in 26% of patients. All 43 eyes (3 lost to follow-up after intervention) had successful management of corneal ulceration/perforation. Twenty-eight eyes with ulceration required medical management alone in 15 eyes, soft contact lens and isobutylcyanoacrylate in 12 eyes, and amniotic membrane grafting in one eye. Four eyes with ulceration worsened and required penetrating keratoplasty (n = 2), and amniotic membrane grafting (n = 2). Corneal perforations were successfully managed with isobutylcyanoacrylate patch and BCL (n = 15), corneal patch graft (n = 2) and multilayered amniotic membrane grafting (n = 1). The average time taken for ulcers to heal was 49 days over a mean follow-up duration of 10 months.

Conclusion

Corneal ulceration or perforation in Sjogren’s syndrome is often sterile and can be a presenting sign of undiagnosed SS. These patients usually respond to intensive medical therapy and bandage contact lens and isobutylcyanoacrylate patch application.

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Fig. 1: Corneal ulceration and perforation in Sjogrenʼs syndrome.

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Data availability

Raw data is available with authors and can be shared upon reasonable request.

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Acknowledgements

We thank Dr Zarin Modiwala, MBBS for her support in data collection and Dr Savitri Sharma, MBBS, MD, Dr Joveeta Joseph, MBBS, DNB, Mr. Venkateshwara Rao, Mr. Balakrishna, Mrs. Renuka, Mr. Gorappa, Laboratory technicians, Jhaveri Microbiology Centre, L V Prasad Eye Institute, Hyderabad for microbiological data.

Funding

Hyderabad Eye Research Foundation (HERF), India.

Author information

Authors and Affiliations

  1. Centre for Ocular Regeneration (CORE), L V Prasad Eye Institute, Hyderabad, Telangana, India

    Swati Singh & Sayan Basu

  2. Brien Holden Eye Research Centre (BHERC), L V Prasad Eye Institute, Hyderabad, Telangana, India

    Swati Singh & Sayan Basu

  3. The Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India

    Simmy Chaudhary & Sayan Basu

  4. Department of eyeSmart EMR & AEye, L V Prasad Eye Institute, Hyderabad, Telangana, India

    Anthony Vipin Das

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  1. Swati Singh
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  2. Simmy Chaudhary
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  4. Sayan Basu
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Contributions

SS and SB were responsible for designing the study protocol, writing the protocol and IRB, conducting the literature review and writing the manuscript along with interpreting results, and creating tables. SC and AVD were responsible for extracting the data from electronic records and analysing data and interpreting results.

Corresponding author

Correspondence to Sayan Basu.

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Singh, S., Chaudhary, S., Das, A.V. et al. Presentation, aetiology and outcomes of corneal ulceration in Sjogren’s Syndrome. Eye 37, 3217–3220 (2023). https://doi.org/10.1038/s41433-023-02494-z

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