SJÖGREN'S SYNDROME AND OCULAR MANAGEMENT FROM THE OPHTHALMOLOGIST'S VIEWPOINT

Abstract

Introduction: Primary Sjögren's syndrome is a chronic and progressive autoimmune disorder characterized by lymphocytic infiltration that mainly affects the salivary glands and lacrimal glands, generating, respectively, xerostomia and xerophthalmia. This syndrome has as main symptoms hyperemia, foreign body sensation and pruritus that can be aggravated in activities that require more time of ocular fixation, compromising ocular lubrication and may lead to severe ocular complications. Although there is no cure, symptomatic management and treatment of complications are critical to improving patients' quality of life. Objective: The aim of the study was to analyze Sjögren's Syndrome and ocular management in the view of the ophthalmologist. Methodology: For the elaboration of this literature review, a search for scientific articles was carried out in the Virtual Health Library (BVS) and National Library of Medicine electronic databases of PubMed. The descriptors used were: Eye and Primary Sjögren, with 745 articles found in Pubmed and 57 articles in VHL. For the selection of articles, inclusion criteria were those that contained scientific correlation on xerophthalmia caused by Sjogren's Syndrome and the main therapeutic approaches. As for the exclusion criteria, articles published more than 8 years ago were discarded, totaling 7 articles selected in the VHL and 7 articles in Pubmed. Results and Discussion: Therapeutic approaches for Sjögren's Syndrome include local and systemic treatments. Local treatments such as artificial tears, tear plugs and corticosteroids are commonly used to relieve symptoms. Systemic drugs such as pilocarpine and cevimeline are also effective in treating ocular symptoms. Other therapeutic options include the use of sodium diquafosol, autologous serum, topical tacrolimus and therapeutic contact lenses. Fecal transplantation is a promising approach, but still needs further studies to determine its effectiveness and the best way of administration. Personalized treatment based on individual patient needs is critical to improving symptoms and quality of life for patients with Sjögren's Syndrome. Conclusion: Pharmacological treatments have been increasing in recent years, which consequently improves the support provided by the ophthalmologist to the patient with Sjögren's Syndrome, and over the years, disease-modifying drugs promise to act, more and more, in a more effective in the glands affected by this syndrome, thus benefiting the quality of life of patients with the syndrome.