Dry Eye Syndrome in Rheumatoid Arthritis Patients
Polanská V.1, Hlinomazová Z.1, Fojtík Z2., Němec P.3
1Oční klinika LF MU a FN, Brno, přednostka prof. MUDr. Eva Vlková, CSc. 2II. interní klinika LF MU a FN, Brno, přednosta prof. MUDr. Jiří Vorlíček, CSc. 3II. interní klinika LF MU a FN u sv. Anny, Brno, přednosta doc.MUDr. Miroslav Souček, CSc |
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Summary:
The aim of this cross-sectional study was to review the incidence of the dry eye
syndrome in rheumatoid arthritis (RA) patients, evaluate the association
among the incidence of the dry eye syndrome, presence of positive rheumatoid
factor (RF), the RA stage, and the duration of the disease.
The group consisted of altogether 100 patients, 16 men and 84 women; the
average age was 58.9 years (SD 14.6). The average duration of RA was 12.3 years,
SD 11.0. In each patient, the Schirmer test I was performed, the presence of the
LIPCOF (Lid Parallel Conjunctival Folds) on the slit lamp was assessed, the
BUT (Tear Break-Up Time) was measured and vital fluorescein staining was
performed. In each patient the data of the presence or absence of the RF in the
serum, RA severity according to the X-ray examination, and the disease
duration were recorded. The Pearson’s association test for nominal variables
was used for statistical evaluation of the association between the rheumatoid
arthritis presence and the dry eye syndrome.
In our group of 100 patients, the Schirmer test I was positive in 67 % of patients.
Positive BUT was marked in 84 % of patients. The conjunctival folds were
present in 45 % of patients only. The pathological findings after cornea
fluorescein staining appeared in 18 % of patients. The dry eye syndrome
incidence was marked in 74 % of patients with RA. Subjective difficulties were
declared by 38.3 % of patients only. The local treatment was already established
in 23.0 % of patients only. We did not find statistically significant correlation
between the RF positive rheumatoid arthritis appearance and dry eye
syndrome, nor between the stage of the rheumatoid arthritis and presence of
the dry eye syndrome. We proved statistical connection between the presence
of dry eye syndrome and the duration of rheumatoid arthritis longer than 10
years. Keratoconjunctivitis sicca is the most common ocular complication in
rheumatoid arthritis patients. We proved the connection between the dry eye
syndrome presence and duration of the RA longer than 10 years; we did not find
the dependence among the RF presence and stage of the rheumatoid arthritis
and the appearance of the dry eye syndrome. The early diagnosis of the dry eye
syndrome and the effective local therapy may prevent very serious corneal
complications, which are difficult to treat.
Key words:
dry eye syndrome, keratoconjunctivitis sicca, rheumatoid arthritis,
corneal complications.
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