OCULAR MANIFESTATIONS OF RHEUMATOID ARTHRITIS – A CASE SERIES ANALYSIS
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Keywords
Rheumatoid arthritis, ocular manifestations, keratoconjunctivitis sicca, dry eyes, peripheral ulcerative keratitis, episcleritis, scleritis, steroid induced cataract, hydroxychloroquine induced maculopathy, Rheumatoid factor, Schirmer’s test
Abstract
Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disorder primarily affecting joints, but it can also involve extra-articular manifestations, including cardiac, eyes, skin, pulmonary, renal, skeletal. Aim of our study is to evaluate the ocular manifestations of rheumatoid arthritis. The cases included patients of varying diseases, duration and severity, exhibiting ocular symptoms. The results show that dry eye syndrome being most common, followed by episcleritis and scleritis, peripheral ulcerative keratitis, anterior necrotizing scleritis without inflammation (scleromalacia perforans) and complications occurring post treatment with oral steroids. This case series presents an analysis of ocular manifestations in patients with RA, highlighting the diverse range of ocular complications associated with disease. This gives the importance of regular ophthalmic evaluations in RA patients to detect and manage ocular complications early, providing better outcomes and improving quality of life.
References
2. Ravulaparthi, Gayathri; Bandla, Bhavagna; Visala, N Venkata1. Ocular disease as the presenting sign of rheumatoid arthritis – An observational case series. Indian Journal of Ophthalmology 71(4):p 1647-1651, April 2023. | DOI: 10.4103/IJO.IJO_2765-22
3. Vignesh APP, & Srinivasan R. (2015). Ocular manifestations of rheumatoid arthritis and their correlation with anti-cyclic citrullinated peptide antibodies. Clin Ophthalmol 2015;9:393-7.
4. Grassi W, De Angelis R, Lamanna G, Cervini C. The clinical features of rheumatoid arthritis. Eur J Radiol. 1998 May; 27 Suppl 1:S18-24. doi: 10.1016/s0720-048x(98)00038-2.
5. Z.H. Eldaly et al./ The Egyptian Rheumatologist 42 (2020)
6. Bhamra MS, Gondal I, Amarnani A, Betesh S, Zhyvotovska A, et al. (2019) Ocular Manifestations of Rheumatoid Arthritis: Implications of Recent Clinical Trails. Int J Clin Res Trails 4: 139. doi: http://doi.org?10.153344/2456-8007/2019/139
7. Cunningham ET Jr, McCluskey P, Pavesio C, Wakefield D, Zierhut M. Scleritis. Ocul Immunol Inflamm. 2016;24 (1):2-5. doi: 10.3109/09273948.2016.1136190.
8. Gupta Y, Kishore A, Kumari P, Balakrishnan N, Lomi N, Gupta N, Vanathi M, Tandon R. Peripheral ulcerative keratitis. Surv Ophthalmol. 2021 Nov-Dec;66(6):977-998. doi: 10.1016/j.survophthal.2021.02.013.
9. Aletaha D, Smolen JS. Diagnosis and Management of Rheumatoid Arthritis: A Review. JAMA. 2018 Oct 2;320(13):1360-1372. doi: 10.1001/jama.2018.13103.
10. Radu A-F, Bungau SG. Management of Rheumatoid Arthritis: An overview. Cells. 2021; 10(11):2857. http://doi/org/10.3390/cells10112857
11. Jaichander, Roshan Christina; Thomas, Reji Koshy; Shobha, Vineeta1. A study to determine the effect of hydroxychloroquine (HCQ) on central corneal thickness (CCT) in patients with rheumatoid arthritis (RA). Indian Journal of Ophthalmology 72(2):p 270-274, February 2024. | DOI: 10.4103/IJO.IJO_3052_22
12. Gerosa M, De Angelis V,Riboldi P, Meroni PL. Rheumatoid arthritis: a female challenge. Womens Health (Lond). 2008 Mar;4(2):195-201. doi: 10.2217/17455057.4.2.195.
13. Dammacco R, Guerriero S, Alessio G, Dammacco F. Natural and iatrogenic ocular manifestations of rheumatoid arthritis: A systematic review. Int Ophthalmol 2022;42:689-711.
14. Guellec D, Cozien S, Ruyssen-Witrand A, Dieude P, Saraux A. Prevalence and clinical significance of extra-articular manifestations at diagnosis in the ESPOIR cohoty with recent-onset arthritis. Semin Arthritis Rheum 2020;50:409-13.
15. Singh S, Das AV, Basu S. Ocular involvement in Sjogren syndrome: Risk factors for severe visual impairment and vision-threatening corneal complications. Am J Ophthalmol 2021;225:11- 7.
16. Reddy SC, Gupta SD, Jain IS, Deodhar SD. Ocular manifestations of rheumatoid arthritis. Indian J Ophthalmol 1977;25:20.
17. Sainz de la Maza M, Foster CS, Jabbur NS. Scleritis associated with systemic vasculitis diseases. Ophthalmology 1995; 102:687-92.
18. Wu C, Yu H, Yen J, Tsai W, Liu H. Rare extra-articular manifestation of rheumatoid arthritis: scleromalacia perforans. Kaohsiung J Med Sci. 2005;21:233-5.
19. Fürst C, Smiley WK, Ansell BM. Steroid cataract. Ann Rheum Dis. 1966 Jul;25(4):364-8. doi: 10.1136/ard.25.4.364.
20. Oderinlo O, Bogunjoko T, Hassan AO, Idris O,Dalley A, Oshunkoya L, Odubela T. Normal central foveal thickness in a thousand eyes of healthy patients in sub Saharan Africa using fourier domain optical coherence tomography. Niger J Clin Pract. 2023 Mar;26(3):331-335. doi: 10.4103/njcp.njcp_318_22.
21. Hasan, Z., Mohammed, S., Abdelmohsen, F. (2019). Ocular Manifestations of Rheumatoid Arthritis and Complications of Hydroxychloroquine Treatment. The Egyptian Journal of Hospital Medicine, 77(3), 5148-5154. doi: 10.21608/ejhm.2019.52404.
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Dr. K. Roshitha Gagarin
Junior resident, Department of Ophthalmology, Tagore Medical College, Chennai
Dr. M. Krithika
Assistant Professor, Department of Ophthalmology, Tagore Medical College, Chennai
Dr. T. Prem Sai
Assistant Professor, Department of Ophthalmology, Tagore Medical College, Chennai
Dr. C. M. Kalavathy
Professor, Head of Department, Department of Ophthalmology, Tagore Medical College, Chennai