A follow-up study of the progress of keratoconjunctivitis sicca and response to treatment in primary Sjögren's syndrome.

Thirty-four patients with Sjögren's syndrome were retrospectively examined in order to evaluate longitudinal alterations in objective ocular disease parameters and their possible relation to systemic bromhexine treatment. Twenty-three patients (68%) were initially found to respond to peroral bromhexine treatment and were subsequently treated with this agent in addition to tear substitutes. The other 11 patients (32%) were considered bromhexine non-responders and were treated with topical agents only. The bromhexine non-responders had a significantly (p less than 0.02) more reduced tear gland function, evaluated by the Schirmer-1 test, than the responder group. At the end of the follow-up period the conjunctival surface cells were significantly (p less than 0.02) more damaged in the bromhexine non-responders than in the responders. The bromhexine non-responders improved in both break-up time and van Bijsterveld score in the course of time while the responders improved in the van Bijsterveld score only. No differences as regards extraglandular disease manifestations, serological abnormalities or treatment with other systemic agents were found between the bromhexine responders and non-responders.