Study finds associations between eye changes, immune activity
Eye surface changes were linked to alterations throughout body

A study found significant associations between eye surface changes and alterations in immune activity throughout the body in people with primary Sjögren’s disease.
“These results provide new insights into the relationship between ocular surface and systemic [whole body] status in patients with [primary Sjögren’s disease],” the researchers wrote.
The study, “Correlation among ocular surface changes and systemic hematologic indexes and disease activity in primary Sjögren’s syndrome: a cross-sectional study,” was published in BMC Ophthalmology.
Sjögren’s disease is an autoimmune disorder that characteristically causes inflammation in the glands that produce tears and saliva. Sjögren’s is considered primary if it appears on its own, or secondary if it develops in association with an underlying health problem.
Eye symptoms, such as dry eyes, are common among people with Sjögren’s disease due to inflammation in tear-producing glands. Dry mouth due to inflammation in the salivary glands is another common symptom. The disease also can cause inflammation in other parts of the body in some patients.
Eye changes and disease activity
The researchers, in China, noted a “lack of research on the relationship between ocular changes and systemic disease activity,” saying that “whether ocular changes occur in isolation or are associated with systemic disease requires further investigation.”
They set out to investigate the possible relationship between eye surface changes and systemic alterations occurring throughout the body in Sjögren’s disease patients.
The study involved 33 people with primary Sjögren’s disease and 36 people without the disorder who served as controls. Most participants in both groups were women.
The researchers conducted detailed examinations of the participants’ eyes, including physical assessments of eye health and measurements of levels of inflammatory molecules in tears, as well as patient-reported measures of eye symptom severity. They also collected blood samples to look at hematologic (blood) indexes of body-wide inflammation and assessed standard measures of systemic disease activity. With these data in hand, they looked for statistically significant associations among the different variables.
They identified dozens of statistically significant correlations. For example, scores on the Ocular Surface Disease Index (OSDI) questionnaire, a measure of dry eye symptoms, were significantly associated with the scores on the EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI), a patient-reported measure of disease activity. Significant associations were also found between OSDI scores and the levels of anti-U1-snRNP autoantibodies in the blood.
Levels of several inflammatory signaling molecules in tears were significantly correlated with scores on different domains of the EULAR Sjögren’s Syndrome Disease Activity Index (ESSDAI), a measure of systemic disease activity. There also were many correlations identified between inflammatory markers in the eyes and autoantibodies and immune cell counts in the blood.
Overall, the data showed that “ocular surface changes in [primary Sjögren’s disease] patients were significantly correlated with systemic hematologic indexes and disease activity,” the researchers wrote.