Superior limbic keratoconjunctivitis (SLK) and its association to systemic diseases Queratoconjuntivitis límbica superior (QLS) y su asociación a enfermedades sistémicas
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Introduction: Superior limbic keratoconjunctivitis (SLK) is a chronic inflammatory disease of the superior bulbar conjunctiva, limbus and upper cornea of unknown etiology. The disease has been associated with thyroid dysfunction in up to 30% of cases. There is scant information about this disorder in the Mexican population. Materials and methods: We conducted a retrospective, longitudinal, and observational study of patients with SLK seen between 1997 and 2011 at our Institution. Parameters analyzed were: age at presentation, sex, symptomatology, clinical manifestations and clinical course, as well as its association with systemic disease. Results: A total of 45 patients, 38 (84.4%) women, seven (15.6%) men (ratio, 5.4:1) were included in the study. Mean age at presentation was 47.5 years, and mean follow-up time was 47.6 months. Thyroid dysfunction was found in 24.2% of cases: 17.6% had hypothyroidism, and 6.6% hyperthyroidism. Sjögren syndrome was found in 17% of cases. Discussion: The prevalence of thyroid dysfunction was 24.2%, with most patients showing hypothyroidism. The correlation between poor thyroid disease control and exacerbations of SLK was uncertain. Patients with Sjögren syndrome and keratoconjunctivitis sicca had a worse initial visual acuity compared with patients without the disease. Conclusion: Although the role of thyroid dysfunction on the pathogenesis of SLK is still unclear, it is interesting to note the relationship between these two disorders, as well as other systemic autoimmune diseases such as Sjögren's syndrome. © 2013 Sociedad Mexicana de Oftalmología.