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Tear film osmolarity and rheumatic disease activity in patients with rheumatoid arthritis

Poster Details

First Author: M.Schargus GERMANY

Co Author(s):    F. Wolf   M. Feuchtenberger   G. Geerling        

Abstract Details


Secondary Sjögren’s Syndrome has a known association with rheumatoid arthritis and tear osmolarity is a known predictor of dry eye disease. This study aimed to identify any relationship between tear film osmolarity and rheumatoid disease activity parameters.


University Eye Hospital Wuerzburg, Germany; Department of Rheumatology and Clinical Immunology, Medizinische Klinik and Poliklinik II, Wuerzburg, Germany


This study involved 87 rheumatoid arthritis patients (30 with self-reported dry eye and 57 without). All were assessed for dry eye disease, using tear osmolarity measurement and conventional tests. Rheumatoid arthritis disease activity was evaluated using Disease Activity Score DAS28. Analyses were performed using hyperosmolarity definitions of >316 and >312 mOsm/l. Osmolarity measurements were taken from both eyes of each patient, and the higher of the two values obtained was used for analysis.


DAS28 was found to significantly correlate with tear osmolarity (when hyperosmolarity was defined as >316 mOsm/l). Specifically, the majority (80.6%) of patients with low rheumatoid activity had normal tear osmolarity, whereas most (66.7%) patients with high rheumatoid activity had hyperosmolar tears (p=0.016). A similar trend occurred when hyperosmolarity was defined as >312 mOsm/l, although nonsignificant (p=0.078). No significant relationship was identified between tear osmolarity and c-reactive protein (CRP) or rheumatoid factor (RF).


Tear film osmolarity is associated with rheumatic disease activity, when assessed by DAS28 score and when hyperosmolarity is defined as >316 mOsm/l. Our findings suggest that patients with high rheumatoid arthritis activity have an increased risk for dry eye disease. The TearLab Osmolarity system may be worthwhile in the management of rheumatoid arthritis patients. FINANCIAL DISCLOSURE?: No

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