According to the Copenhagen criteria for Sjogren's syndrome, the diagnosis of keratoconjunctivitis sicca requires the performance of 3 objective ocular tests, with 2 showing pathological results. A common panel is the Schirmer-1 test, the break-up time and Rose-Bengal score. By dividing clinical ophthalmological tests into 3 groups based on the characteristic functions of the lacrimal system, the results of different testing panels can be compared.
Parameter
Test
Abnormal Result
tear production
Schirmer-1 test
<= 10 mm in 5 minutes
tear lysozyme
<= 1.4 g/L
tear lactoferrin
<= 1.1 g/L
tear IgA
<= 0.8 g/L
tear quality
break-up time
<= 10 seconds
osmolarity
>= 320 mosmol
ferning test
III or IV
ocular surface
Rose-Bengal score
>= 4 (in range 0-9)
sensitivity
< 30 mm
imprint biopsy p12
positive snake (snake-like chromatin)
Testing protocol:
(1) at least one test in each of the 3 parameters should be performed
(2) 2 of the parameters should be abnormal for the diagnosis of keratoconjunctivitis sicca
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