Advanced Dry Eye Management In Rheumatoid Arthritis Patients Using Dual-Polymer Lubricant Eye Drops

To evaluate the efficacy of adding HPG/HA dual polymer eye drops to steroid-based dry eye therapy in improving dry eye symptoms in patients with rheumatoid arthritis (RA) over three months.

This study was conducted in December 2023 at Chang Gung Memorial Hospital in Keelung, Taiwan. It enrolled 39 participants with dry eyes secondary to RA.

This single-centre study involved 39 participants with dry eyes secondary to RA. After a two-week washout period using the balanced salt solution (BSS) and 0.1% fluorometholone (FML) eye drops, they were treated for 12 weeks with HPG/HA dual polymer eye drops in addition to 0.1% FML. The primary and secondary endpoints were changes in the Ocular Surface Disease Index (OSDI) scores, Non-Invasive Tear Break-Up Time (NITBUT), corneal fluorescein staining (CFS), and Schirmer's test scores. These parameters were assessed from baseline to the 12-week follow-up. Participants with recent or planned eye surgeries were excluded. Data analysis focused on the right eye, specifically for NITBUT, CFS, and Schirmer's test scores.

The results presented preliminary data from 23 dry eye participants with stable RA disease severity assessed according to the 2010 ACR/EULAR criteria. Wilcoxon signed-rank test was conducted, and the findings revealed a decrease in mean OSDI scores, which changed from 27.66± 11.75 to 25.34 ± 12.67 (p=0.279). Additionally, the mean NITBUT for the right eye increased from 7.39 ± 3.59 seconds to 8.88 ± 2.89 (p=0.23) seconds. Furthermore, the CFS for the right eye decreased from 5.10 ± 2.93 to 4.15 ± 2.72 (p=0.29). Schirmer’s test results for the right eye slightly reduced from 4.10 ± 2.57 to 4.08 ± 3.57 (p=0.98).

Adding HPG/HA dual polymer eye drops to steroid-based therapy may positively impact ocular surface health and tear film stability in patients with dry eye secondary to RA. The improvement in mean OSDI scores indicates a signal toward reducing the severity of dry eye symptoms. Additionally, the intervention improved mean NITBUT and CFS scores for the right eye, suggesting enhanced tear film stability and corneal health. These findings are based on preliminary results; further analysis with a larger sample size will be conducted upon completion of the study.