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Ocular surface changes in patients with familial mediterranean fever

Poster Details

First Author: M.Kosker TURKEY

Co Author(s):    M. Acar   N. Arslan   A. Sanal Dogan   M. Alp   C. Ozisler   C. Gurdal     

Abstract Details


Ocular involvement is rarely associated with familial Mediterranean fever (FMF). It has been recently postulated that the ocular surface and tear-film functions of FMF patients might be affected due to the chronic inflammatory nature of FMF. The aim in our study was to evaluate the ocular surface changes and tear-film functions in patients with FMF.


Departments of Ophthalmology, Rheumatology, Diagnostic Center of Genetic Diseases, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.


We included 35 consecutive genetically diagnosed patients with FMF (group 1) and 35 controls (group 2) in this prospective study. All patients had genetic analysis of FMF gene mutations to support a clinic diagnosis. Ocular surface changes were evaluated by determining tear-film functions using Schirmer-I, BUT, corneal fluorescein and Lissamine Green tests. All participants completed the Ocular Surface Disease Index (OSDI) questionnaire. A meibomian gland dropout score due to gland loss was obtained. Meibomian gland changes were scored from 0 to 6 (meiboscore). We also measured central corneal epithelial thickness and central corneal thickness. Results were compared between the groups.


32 patients had compound heterozygous mutations and 3 had homozygous mutations. Mean results on Schirmer-I test were 16.65±5.54 mm in group 1 and 17.95±4.15 mm in group 2 (p>0.05). Mean BUT was 4.82±3 seconds in group 1 and 13.31±2.36 seconds in group 2 (p=0.001). Mean corneal fluorescein and Lissamine green staining scores were 2.88±2.88 and 2.15±2.02 in group 1 and 0.21±0.42 and 0.16±0.37 in group 2 (p=0.001). The mean OSDI score was 28.1±21.1 in group 1 and 3.43±7.45 in group 2 (p=0.001). Mebioscore, mean central corneal epithelial thickness and central corneal thickness did not differ significantly between the groups (p>0.05).


Despite normal tear production, the ocular surface and tear-film functions of FMF patients differ from those of healthy individuals. These changes may be related to the chronic inflammatory nature of FMF.

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