Therapeutic Effect of Intense Pulsed Light in Patients with Sjögren's Syndrome Related Dry Eye.

Yanan Huo,Zhiyong Zhang,Zhiyi Wu,Qi Wan,Jinchuan Zhao,Xiuming Jin,Xinzhu Hou

doi:10.3390/jcm11051377

Abstract

This prospective randomized study evaluated the efficacy and safety of intense pulsed light (IPL) and meibomian gland expression (MGX) as polytherapy for Sjögren’s Syndrome-related dry eye (SS-DE). The study enrolled 55 participants with SS-DE, 27 for the treatment group and 28 for the control group. The treatment group underwent three IPL-MGX treatments, three weeks apart. A randomly-selected eye from each patient was assessed at baseline and on weeks 9, 12, and 15 for Snellen best-corrected visual acuity (BCVA), intraocular pressure, Ocular Surface Disease Index (OSDI) score, conjunctival congestion, tear meniscus height, non-invasive tear breakup time (NBUT), Schirmer’s I test (SIT), corneal fluorescein staining (CFS), meibomian gland (MG) dropout, eyelid margin abnormality, MGX and meibum quality. OSDI, NBUT, CFS, MGX, and meibum quality were significantly improved in both groups, particularly in the treatment group. The eyelid margin abnormality improved significantly in the treatment but not in the control group on weeks 12 and 15. Snellen BCVA, conjunctival congestion, and SIT improved significantly in the treatment group, but the two groups were statistically similar. Our results indicated that three IPL-MGX sessions could significantly improve the subjective and objective characteristics of SS-DE, representing a promising treatment strategy.

Highlights

Sjögren’s syndrome (SS) is an autoimmune disease characterized by the lymphocytic infiltration of the moisture-producing glands, including the sebaceous, sweat, salivary, and lacrimal glands, resulting in its two most common symptoms: dry eyes (DE) and a dry mouth [1,2]
One patient in the intense pulsed light (IPL)-meibomian gland expression (MGX) group could not adhere to the follow-up schedule due to the COVID-19 quarantine policy and left the study
Four of the control group patients left the study because they saw no relief in their DE symptoms

Summary

Introduction

Sjögren’s syndrome (SS) is an autoimmune disease characterized by the lymphocytic infiltration of the moisture-producing glands, including the sebaceous, sweat, salivary, and lacrimal glands, resulting in its two most common symptoms: dry eyes (DE) and a dry mouth [1,2]. SS-DE might have a range of ocular presentations, the most common is keratoconjunctivitis sicca (KCS). DE was conveniently divided into the aqueous-deficient and evaporative subgroups. These two DE subgroups differ in the pathophysiological and background aspect of their DE. Patients with SS are classified exclusively into the aqueous-deficient DE subgroup because their damaged lacrimal glands secrete less of the tears’ aqueous portion, but they might present meibomian gland (MG) dysfunction (MGD) [5]. Patients with SS should be treated for both DE subtypes

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Discussion

Conclusion