Ocular Manifestations in Rheumatoid Arthritis: A Descriptive Cross-Sectional Study from Iraq

Abstract

Background: Ocular involvement.is one of the most important extra articular manifestation of rheumatoid arthritis (RA)

Objective: To evaluate the ocular manifestations in patients with RA.

Patients and Methods: A cross sectional study was conducted on (103) patients with RA diagnosed according to either 1987 revised American College of Rheumatology (ACR) criteria or the 2010 ACR /European League Against Rheumatism (EULAR) criteria for diagnosis of RA. Baseline demographic and clinical characteristics of patients were recorded. Ocular manifestations were assessed in all patients.

Results: A total of 103 patients with RA enrolled in this study, the mean age was 41.5 years with a female to male ratio of 7.6: 1. A positive serum for rheumatoid factor was obtained in 72.8% of patients, and a positive anti-cyclic citrullinated peptide antibody (ACPA) was obtained in 69.9% of patients. Dry eyes were the most frequently identifiable ocular manifestation (27.2%), followed by drug induced ocular disease (12.6%), in this category, posterior subcapsular cataract ranked first (8.7%), followed by blepharitis (3.9%). The occurrence of ocular inflammatory diseases was 8.7%, among this category of ocular diseases, conjunctivitis was at the top of the list (5.8%). A significant correlation was found between ocular dryness with RF, ACPA, high disease activity and treatment with biological drugs.

Conclusions: The prevalence of ocular findings in patients with RA was 57.2%. The commonest was ocular dryness followed by posterior subcapsular cataract, other types of cataract, conjunctivitis, blepharitis, uveitis, episcleritis, keratitis and scleromalacia. Ocular dryness had a significant correlation with RF, ACPA, high disease activity and treatment with biological drugs but there was no correlation of these predictors with drug induce ocular disease or inflammatory ocular disease. There was no significant correlation between ocular manifestation with age, gender, functional class and disease duration.

Keywords: Rheumatoid arthritis, Ocular manifestations, Dry eyes, Drug induced ocular manifestations, Ocular inflammatory diseases.