Ocular complications of primary Sjögren syndrome in men

Am J Ophthalmol. 2015 Sep;160(3):447-452.e1. doi: 10.1016/j.ajo.2015.06.004. Epub 2015 Jun 17.

Abstract

Purpose: To report the ocular complications of primary Sjögren syndrome (SS) in men.

Design: Retrospective cohort study.

Methods: setting: Tertiary-care SS center.

Patient population: Total of 163 consecutive primary Sjögren syndrome patients evaluated between January 2007 and March 2013.

Main outcome measure: Frequency of extraglandular ocular and systemic manifestations and serologic results in men compared to women.

Results: Fourteen of the 163 primary SS patients (9%) were men. On initial presentation, men were a decade older (61 vs 50 years, P < .01) and less likely than women to have a prior diagnosis of SS (43% vs 65%, P = .09). A majority of men reported dry eye on presentation (92%), albeit less chronic compared to women (5.9 vs 10.8 years, P = .07). Men were more likely to present with serious ocular complications than women (43% vs 11%, P = .001). Extraglandular systemic complications of SS (ie, vasculitis, interstitial nephritis) were also more common in men (64% vs 40%, P = .07). Further, men were more likely to be negative for anti-SSA/Ro, anti-SSB/La, and antinuclear antibodies than women (36% men vs 11% women, P = .01).

Conclusion: Men with primary SS have a higher frequency of serious ocular and systemic manifestations. Although primary Sjögren syndrome is typically considered a disease of middle-aged women, it may be underdiagnosed and consequentially more severe in men. Physicians should have a lower threshold to test for SS in men with dry eye.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antibodies, Antinuclear / blood
  • Conjunctival Diseases / etiology
  • Corneal Diseases / etiology
  • Dry Eye Syndromes / etiology
  • Eye Diseases / blood
  • Eye Diseases / etiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nephritis, Interstitial / etiology
  • Orbital Diseases / etiology
  • Retrospective Studies
  • Scleral Diseases / etiology
  • Sjogren's Syndrome / blood
  • Sjogren's Syndrome / complications*
  • Uveal Diseases / etiology
  • Vasculitis / etiology

Substances

  • Antibodies, Antinuclear
  • SS-A antibodies
  • SS-B antibodies