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Correlation of ocular manifestations with the duration and activity of disease in patients with rheumatoid arthritis

Kezhukkut Jayaraj, Treasa George Alvin, Kakkuzhiyil Skariah Charles, T P Antony.

Abstract
Background: Rheumatoid arthritis (RA) is a chronic inflammatory arthritis which can affect extra-articular tissues including eyes.

Objective: This study was aimed to evaluate the ocular manifestations, their correlation with the duration and activity of disease in patients with RA.

Materials and Methods: Patients diagnosed with RA of disease onset age >20 years, irrespective of sex were selected for the study. The eye manifestations were done clinically and also with the help of slit lamp, ophthalmoscope and Schirmer’s test. The findings were statistically analysed.

Result: One hundred cases of RA were selected (mean age 52.54 years). Keratoconjunctivitis sicca was the commonest finding (40%) along with few cases of keratitis (3%), scleritis (1%) and episcleritis (1%). A statistically significant negative correlation was found between the duration of disease and the Schirmer score (r=-0.785; p=0.001). Further, no statistically significant correlation between ocular manifestation and the disease severity were found. Higher ophthalmic involvement was found in seropositive patients.

Conclusion: The commonest ocular manifestation found was keratoconjunctivitis sicca. The frequency and severity of involvement of eyes were found to be significantly associated with the duration of the disease. This emphasizes the need for the routine ophthalmic evaluation of RA patients on a periodic basis for the early detection as well as the prevention of ophthalmic complications and thereby modifying treatment.

Key words: Rheumatoid arthritis, keratoconjunctivitis sicca, episcleritis, keratitis, scleritis


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