{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:16:03Z","timestamp":1778822163344,"version":"3.51.4"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["GR004596\u20101"],"award-info":[{"award-number":["GR004596\u20101"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["NIH Center Core Grant P30EY014801"],"award-info":[{"award-number":["NIH Center Core Grant P30EY014801"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R33EY032468"],"award-info":[{"award-number":["R33EY032468"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01 EY034686"],"award-info":[{"award-number":["U01 EY034686"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U24EY035102"],"award-info":[{"award-number":["U24EY035102"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007496","name":"Biomedical Laboratory Research and Development, VA Office of Research and Development","doi-asserted-by":"publisher","award":["I01 BX004893"],"award-info":[{"award-number":["I01 BX004893"]}],"id":[{"id":"10.13039\/100007496","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015728","name":"Clinical Science Research and Development","doi-asserted-by":"publisher","award":["I01 CX002015"],"award-info":[{"award-number":["I01 CX002015"]}],"id":[{"id":"10.13039\/100015728","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017173","name":"Sj\u00f6gren's Foundation","doi-asserted-by":"publisher","award":["2023\u2010PltGr\u2010109"],"award-info":[{"award-number":["2023\u2010PltGr\u2010109"]}],"id":[{"id":"10.13039\/100017173","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The study aimed to identify symptom\u2010based predictors of dry eye disease (DED) signs in the Sj\u00f6gren's International Collaborative Clinical Alliance (SICCA) cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective analysis examining 16 ocular symptoms (most graded 0\u20134) and artificial tear (AT) use (graded 0\u20133) as predictors of DED signs (abnormal ocular surface staining [OSS] and Schirmer's test [ST], graded yes\/no). Symptoms included descriptors of spontaneous and evoked pain, visual complaints, and other metrics (eg, redness). Logistic regressions were used for univariable and multivariable analyses, with OSS and ST as outcome variables. Hierarchical analyses were performed to identify symptom\u2010based clusters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean age of the population (n\u00a0=\u00a03,514) was 53\u2009\u00b1\u200913 years; 91% were female, 54% were White, and 44% met 2016 criteria for Sj\u00f6gren disease. On multivariable analysis, OSS was positively related to AT use (odds ratio [OR] 1.51, 95% confidence interval [CI] 1.36\u20131.67), eye redness (OR 1.17, 95% CI 1.08\u20131.26), and blurred vision (OR 1.11, 95% CI 1.02\u20131.20). Similarly, eyes that felt dry, AT use, and blurred vision were positively related to ST. Cluster analysis revealed three groups with varied symptom burden (low, mild\u2010moderate, and high). The mild\u2010moderate cluster had higher frequencies of abnormal ocular signs and positive serologic test results (anti\u2010SSA\/Ro antibody, elevated IgG level) compared to the high symptom burden cluster.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AT use and blurred vision were stronger indicators of ocular surface and tear film abnormalities than pain symptoms, and their presence merits an ophthalmology referral. Symptom\u2010based clustering revealed varied symptom burden groups, likely driven by underlying neurotrophic and neuropathic mechanisms, highlighting heterogeneity within sicca presentations and the need to develop phenotype\u2010based targeted therapies.<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/acr80057-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.80057","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T12:20:46Z","timestamp":1776082846000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cracking the Code: Which Ocular Symptoms Predict Dry Eye Signs? 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