Comparative Focus: Tear Lactoferrin Alterations In Reactive Arthritis Patients Stratified By Triggering Infection: A Prospective Case-Control Study

To evaluate anterior segment changes and tear lactoferrin levels in patients with reactive arthritis and compare findings with healthy controls

30 patients (60 eyes) with confirmed reactive arthritis examined at the Multidisciplinary Clinic of Tashkent Medical University, Republican Specialized Scientific and Practical Medical Centre of Eye Microsurgery

Tashkent, Uzbekistan

Prospective case-control study. Inclusion: patients with reactive arthritis presenting with anterior segment ocular complaints, aged 20–45 years. Exclusion: age under 20 or over 45 years; posterior segment complaints. Tear lactoferrin levels were measured and stratified by infection type (Chlamydia trachomatis, Ureaplasma, other infections) and disease course (acute/subacute vs. chronic). A healthy control group was enrolled for comparison.

18 patients were male (60%), 12 female (40%), aged 20–45 years. Anterior segment changes were identified across the study group. Tear lactoferrin levels were consistently higher in chronic cases across all infection types: Chlamydia trachomatis — Acute/Subacute: ~0.12 mg/mL; Chronic: ~0.21 mg/mL Ureaplasma — Acute/Subacute: ~0.09 mg/mL; Chronic: ~0.18 mg/mL Other infections — Acute/Subacute: not detected; Chronic: ~0.51 mg/mL Chronic disease course was associated with markedly elevated lactoferrin levels, most prominently in the "other infections" group. No significant findings were recorded in healthy controls.

Reactive arthritis is associated with clinically significant anterior segment involvement Tear lactoferrin levels correlate with disease chronicity and infection type Chronic ReA, particularly from non-specific infections, shows the greatest biochemical ocular surface disruption Routine ophthalmic screening and lactoferrin monitoring are recommended for all ReA patients Early detection is key to preventing vision-threatening complications.