ABSTRACT
BACKGROUND: Sjögren's syndrome is an autoimmune disease, and its important feature is the lymphocyte infiltration of exocrine glands, including lacrimal glands. It contributes to defects of their activity and causes that one of the main manifestation of Sjögren's syndrome is dry eye. Unfortunately, the discrimination between dry eye related and non-related to Sjögren's syndrome is difficult at the initial stages of diseases. In addition, the available agents for the treatment of Sjögren's syndrome-related dry eye have limited efficacy. AIM: The purpose of this study was to describe and emphasize differences between Sjögren's Syndrome-related dry eye and non-Sjögren's Syndrome-related dry eye together with the determination of novel therapeutic options for Sjögren's Syndrome-related dry eye. METHOD: A review of the relevant papers describing characteristics of Sjögren's Syndrome-related dry eye and its therapy was conducted. This article is based on both pre-clinical and clinical evidences. RESULTS: On the basis of our analysis, we indicated differences between Sjögren's Syndrome-related dry eye and non-Sjögren's Syndrome-related dry eye. Moreover, there are some novel markers that could be used in the diagnosis of Sjögren's Syndrome-related dry eye. In addition, expect artificial tear, other agents e.g. hydroxychloroquine can be effective in therapy of disease. CONCLUSIONS: Sjögren's Syndrome-related dry eye is a disorder, whose diagnosis may be difficult and mistaken for non-Sjögren's Syndrome-related dry eye. However, Sjögren's Syndrome-related dry eye has some specific features. In addition, the development of newer and safer therapeutic agents for Sjögren's syndrome-related dry eye is needed, and therefore further clinical, randomized studies are necessary.
Subject(s)
Dry Eye Syndromes , Sjogren's Syndrome , Dry Eye Syndromes/diagnosis , Dry Eye Syndromes/drug therapy , Dry Eye Syndromes/etiology , Humans , Hydroxychloroquine/therapeutic use , Lubricant Eye Drops/therapeutic use , Sjogren's Syndrome/complications , Sjogren's Syndrome/diagnosis , Sjogren's Syndrome/drug therapy , TearsABSTRACT
PURPOSE: The presentation of complex procedures in preoperative diagnosis, allowing the evaluation of reaction of a patient with bilateral STD syndrome, to a potential change in the long-lasting ocular motility disturbances and corrective head position. MATERIAL AND METHODS: The botuline toxin was injected into the medial rectus muscle of the eye with greater motility disturbance in convergent strabismus. It was discovered during preparation for cataract surgery in a 45 years old female with STD Syndrome I type. Due to reduced visual acuity the diagnosis of binocular vision were performed after bilateral cataract surgery. We were afraid that the fixed sensory status of the patient would change, and therefore we performed botuline injections. Strabismus angle, ocular motility and diplopia were assessed and compared. RESULTS: The reduction of strabismus angle was achieved with no diplopia. The patient no longer needed the corrective head position, with binocular vision present while looking straight ahead. Also, a slight improvement was obtained in the abduction motility of the eye to which botuline toxin was injected. CONCLUSION: Preoperative diagnostic botuline toxin injection into the rectus medial muscle of the eye with greater motility disturbance, gives an effect of strabismus reduction. This allows for further decisions of whether, and what type of surgical treatment should be performed.
Subject(s)
Botulinum Toxins, Type A/therapeutic use , Cataract Extraction/methods , Cataract/complications , Duane Retraction Syndrome , Neuromuscular Agents/therapeutic use , Preoperative Care , Abducens Nerve/physiopathology , Diagnosis, Differential , Diplopia/complications , Diplopia/physiopathology , Duane Retraction Syndrome/complications , Duane Retraction Syndrome/drug therapy , Duane Retraction Syndrome/physiopathology , Female , Humans , Middle Aged , Strabismus/complications , Strabismus/physiopathology , SyndromeABSTRACT
PURPOSE: To evaluate results of surgical complex treatment of lens dislocation in Marfan syndrome cases. MATERIAL AND METHODS: Nineteen eyes of 13 patients were operatively treated for lens dislocation. Pars plana vitrectomy was done in all eyes. Dislocated lenses were removed by lensectomy in 5 eyes and with an intracapsular method in 14 eyes. The scleral fixation technique was used for primary posterior chamber intraocular lens implantation in 18 eyes, and one eye remained aphakic. Time of observation ranged between 6 and 71 months (mean 3.5 years). RESULTS: All eyes achieved improvement in visual acuity or good preoperative visual acuity was maintained. The vision between 6/6 and 6/8 was achieved in 14 patients. There were no serious intraoperative or early postoperative complications. Retinal detachment appeared in two eyes in a long observation time and it was successfully operatively treated. The not good visual results were due to amblyopia (n = 2), complications of retinal detachment surgery (n = 2) and glaucomatous optic disc atrophy coexisting with macular degeneration (n = 1). CONCLUSIONS: Pars plana vitrectomy and primary scleral-fixated IOL implantation gives quick and good visual rehabilitation in adult patients with Marfan's syndrome. The described surgical method is complex and need a prolonged operative time, but gives very good functional results and very few complications.
