TEAR MUCUS FERNING IN PATIENTS WITH SJOGRENS-SYNDROME

The purpose of this study is to evaluate the possibility of using the mucus ferning phenomenon of the tears as a diagnostic test for Keratoc onjunctivitis sicca in patients with Sjogren's syndrome. Using a polar ising light microscope dried samples were tested for ferning phenomeno n collected from (1) 36 healthy controls, (2) 21 patients with primary Sjogren's syndrome, and (3) 15 patients with secondary Sjogren's synd rome. Patients with Sjogren's had xerostomia, abnormal salivary gland biopsy and at least two positive tests for Keratoconjunctivitis sicca. Patterns of mucus crystallization were classified into 5 types accord ing to uniformity, branch spreading and integrity (types I, II normal, types III, IV, V abnormal). Abnormal ferning was found in tear sample s of 8 out of 72 normal control eyes, 38 out of 42 with primary Sjogre n's syndrome and 25 out of 30 with secondary Sjogren's syndrome. The d ifferences between both primary and secondary Sjogren's syndrome, in c omparison to healthy controls, were significant (p < 0.001). The sensi tivity of the method was found 90% for primary Sjogren's syndrome and 80% for secondary Sjogren's syndrome. According to our data, tear mucu s ferning test is a simple, sensitive and specific test to estimate Ke ratoconjunctivitis sicca in patients with Sjogren's syndrome.