We continued investigating the natural history and treatment of the autoimmune exocrinopathy, Sjogren's Syndrome, which is associated with a particularly severe form of dry eye in which the pathogenesis may include sex hormone insufficiency and dysregulated immune regulation. Specifically, protocol 06-D-0181, A randomized placebo controlled, proof of concept study of Raptiva, a humanized anti-CD11a monoclonal antibody in patients with Sjogren's syndrome, is nearing completion. ? ? With continued interest with in improving the tools for diagnosis and evaluation of dry eye, we co-authored a publication describing the menisci and importance of blink magnitude in dry eye. Dry eye affects 5-30% of the population over the age of 50 years and risk factors include female sex, age, sex hormone alterations, refractive surgery, particular medications and infections and a variety of specific clinical diseases such as graft vs. host disease. Vision targeted health-related quality of life (QOL) instruments quantify an aspect of dry eye that is not measured in other ways. A wide variety of validated instruments that measure QOL and symptoms are available; however, clinically meaningful changes remain to be defined. We have begun a clinical protocol to evaluate the comparability of QOL instrument in dry eye and control subjects administered via the web or conventional completion with paper and pen. ? ? Data analysis of the ocular response from a placebo-controlled, randomized controlled trial of systemic testosterone treatment in women with premature ovarian insufficiency remains ongoing. As part of our interest in outcome measures for ocular surface disease, data analysis is near completion from a one of its kind study on validation of digital imaging of ocular surface vital dye staining as an outcome measure for clinical trials.

National Institute of Health (NIH)
National Eye Institute (NEI)
Intramural Research (Z01)
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U.S. National Eye Institute
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Smith, Janine; Nichols, Kelly K; Baldwin, Edward K (2008) Current patterns in the use of diagnostic tests in dry eye evaluation. Cornea 27:656-62
Yeh, Steven; Smith, Janine A (2008) Management of acute hydrops with perforation in a patient with keratoconus and cone dystrophy: case report and literature review. Cornea 27:1062-5
Harrison, Wendy W; Begley, Carolyn G; Liu, Haixia et al. (2008) Menisci and fullness of the blink in dry eye. Optom Vis Sci 85:706-14
Nichols, Kelly K; Foulks, Gary N; Schaumberg, Debra A et al. (2008) The changing times in dry eye research. Optom Vis Sci 85:613-4
Cortes, Lizette M; Mattapallil, Mary J; Silver, Phyllis B et al. (2008) Repertoire analysis and new pathogenic epitopes of IRBP in C57BL/6 (H-2b) and B10.RIII (H-2r) mice. Invest Ophthalmol Vis Sci 49:1946-56
(2007) The epidemiology of dry eye disease: report of the Epidemiology Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf 5:93-107
Smith, Janine A (2007) Toward optimal health: Janine A. Smith, M.D., discusses vision impairment in women: interviewed by Jodi Godfrey. J Womens Health (Larchmt) 16:293-8
Lekhanont, Kaevalin; Park, Choul Yong; Smith, Janine A et al. (2007) Effects of topical anti-inflammatory agents in a botulinum toxin B-induced mouse model of keratoconjunctivitis sicca. J Ocul Pharmacol Ther 23:27-34
(2007) Methodologies to diagnose and monitor dry eye disease: report of the Diagnostic Methodology Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf 5:108-52
John-Aryankalayil, Molykutty; Dushku, Nicholas; Jaworski, Cynthia J et al. (2006) Microarray and protein analysis of human pterygium. Mol Vis 12:55-64

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