Ocular Involvement in Sjögren’s Syndrome: Advances in Therapy

Abstract

This article seeks to identify immunomodulatory therapy that holds promise for managing the ocular features of Sjögren’s syndrome. There is an unmet need in therapies that can modulate the inflammatory damage that mediates keratoconjunctivitis sicca. While tear substitutes abound, there is a possibility that prevention of lacrimal gland and conjunctival inflammation may preserve tear production. Topical immunomodulatory therapy can improve some of the signs of keratoconjunctivitis sicca. Systemic immunomodulatory therapy appears to improve symptoms of ocular dryness, but improvement of signs of dry eye disease can be equivocal. Topical immunomodulatory therapy can be effective in managing some of the signs of keratoconjunctivitis sicca. Systemic immunomodulatory therapy may play a role in managing or preventing the systemic inflammation that can lead to dry eye disease, but systemic therapy is currently employed when there are also systemic complications in Sjögren’s syndrome. Future studies are needed to elucidate the utility of systemic immunomodulatory therapy in refractory cases of keratoconjunctivitis sicca.