ArticleBMC ophthalmology2026
Corneal epithelial thickness profiles in dry eye patients with or without primary Sjögren's syndrome.
Article in BMC ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo describe corneal thickness (CT) and corneal epithelial thickness (CET) in dry eye patients with/without primary Sjögren’s syndrome (pSS-DED/nSS-DED) and evaluate potential associations with dry eye symptoms and signs.
methods181 pSS-DED patients and 133 nSS-DED patients were recruited from dry eye outpatient of Peking University Third Hospital from December 2020 to December 2024. The pSS-DED patients were further diagnosed by rheumatologists. All participants received symptom assessment, slit lamp examination, Schirmer I test and optical coherence tomography (OCT) examination.
resultspSS-DED patients had a higher ocular surface disease index questionnaire (OSDI) (20.31 vs. 16.89, P = 0.006), lower Schirmer I test value (P = 0.003), and lower fluorescein tear break-up time (FBUT) (P < 0.001) than nSS-DED patients. Among corneal thickness profiles, pSS-DED patients had thinner total corneal thickness (CT), including CT average (CTAV, P = 0.021), CT minimum (CTmin, P < 0.001), CT maximum (CTmax, P < 0.001), and so on. Critically, pSS-DED patients also exhibited significant alterations in epithelial profiles, including thinner superior corneal epithelium (SCET, P = 0.013), thinner minimum epithelium (CETmin, P = 0.040), and significantly greater epithelial thickness variability (CETSD, P = 0.005). Correlation analysis further revealed that epithelial variability (CETSD) was significantly associated with worse OSDI symptoms (r = 0.25) and thinner superior epithelium (r=-0.33). Multivariate logistic regression identified FBUT (OR = 0.697), CTmin (OR = 0.958), CTmax (OR = 0.986), central corneal stromal thickness (CCST, OR = 1.039), epithelial variability (CETSD, OR = 1.398), and superior-inferior stromal difference (SCST-ICST, OR = 1.017) as significant independent predictors for differentiating the groups. Receiver-operating characteristic (ROC) curve analysis revealed that a combined model integrating these parameters demonstrated high diagnostic efficacy.
conclusionPatients with pSS-DED exhibited lower CT profiles and thinner, more variable CET profiles. These structural alterations likely reflect the chronic inflammatory and neurosensory pathology of pSS. The integration of OCT-derived corneal parameters with traditional clinical signs may serve as objective biomarkers to support the differentiation of pSS-DED from nSS-DED.
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