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Research
Summary
Infectious
and Inflammatory Ocular Diseases
The Sjögren's Clinic study constitutes the largest group of patients
in the U.S. with pathological confirmation of Sjögren's syndrome,
an incurable autoimmune disease causing significant vision problems
as well as dryness of the mouth, which affects 2 to 4 million Americans.
We have been analyzing patient data for 20 years and have established
clinical classification and diagnostic criteria. A collaborative project
of the Francis I. Proctor Foundation
and the Departments of Oral Medicine and Rheumatology, the Clinic
has evaluated over 630 patients with positive labial salivary gland
biopsies and has published a series of papers on the correlation between
ocular and oral clinical findings, with detailed statistical analysis. |
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Sjögren's
Syndrome Studies.
Continuing analysis of this large database will sort out the specific
clinical features associated with primary Sjögren's syndrome
and secondary Sjögren's syndrome (involving connective tissue
disease). We are also evaluating differences in the disease associated
with gender and age. We are looking at the sensitivity and specificity
of tests used to diagnose keratoconjunctivitis sicca (a type of corneal
inflammation) in patients suspected of having Sjögren's syndrome.
We are also evaluating a number of medications in clinical studies.
South India Studies.
Collaborative studies with the largest eye hospital in the world,
Aravind Eye Hospital in Madurai, South India, and the Proctor Foundation
began in 1991 (with Gilbert Smolin, MD). We established the Aravind
Eye Hospital Uveitis Clinic in 1992 (with Robert Nozik, MD).
Our study of the epidimiology and the incidence of corneal ulceration
in South India is the first population-based incidence study of corneal
ulceration in a developing country. Study data indicate that corneal
ulceration is 10 times more common in South India than in the U.S.,
and we estimate that there are more than 1.5 million individuals blinded
every year, worldwide, by central corneal ulcers. We have also completed
and published studies of the epidimiology and diagnosis of uveitis
(inflammation of the middle layer of the eye) in South India (with
Emmett Cunningham, MD, PhD).
The onset of cataracts in India appears in patients from 35 to 50
years old, and cataracts rapidly progress to blindness. Based on early
epidimiology studies (with Gilbert Smolin, MD) we initiated a four-year
cataract prevention study in 1997, administering antioxidants to a
defined population with early cataracts. We anticipate that this study
will definitively clarify whether antioxidants can reduce the onset
and progression of cataracts in a developing country. |
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