Corneal fluorescein staining that appears “patchy” can be seen with or without superficial punctate keratopathy in dry eye disease (DED). A study recently found that this form of corneal fluorescein staining in cases of DED may also indicate an association with Sjögren’s syndrome.

The study included 35 DED patients with and 30 without a patchy fluorescein staining pattern. A team evaluated the tear meniscus radius, tear film lipid layer spread grade, noninvasive break-up time, fluorescein break-up time, corneal epithelial damage, conjunctival epithelial damage, Schirmer’s 1 test and Sjögren’s prevalence.

The researchers observed a statistically significant difference in conjunctival epithelial damage (3.1 NEI points), Schirmer’s test score (5.6 vs. 14.8) and Sjögren’s prevalence (60.0% vs. 16.7%). They did not find clinically meaningful differences in the remaining measurements between the groups.

“Through the findings obtained from this present study, it may be suggested that patchy pattern corneal fluorescein staining is a sign of ocular surface inflammation and that anti-inflammatory treatment is an effective therapy for DED with patchy pattern corneal fluorescein staining,” the study authors concluded in their paper. “Therefore, patchy pattern corneal fluorescein staining may become the key for determining the most appropriate treatment for DED from the point of ocular surface inflammation.”

Komai S, Yokoi N, Kato H, et al. Clinical implication of patchy pattern corneal staining in dry eye disease. Diagnostics. 2021;11(2):232.