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Prevalence of ocular surface abnormalities in rheumatoid arthritis patients and its ‎correlation with disease activity and duration among Egyptian population

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Session Details

Session Title: Cornea - Medical

Session Date/Time: Monday 07/09/2015 | 08:00-10:30

Paper Time: 10:13

Venue: Room 17

First Author: : Z.Eldaly EGYPT

Co Author(s): :    N. Hammam                    

Abstract Details


To present different ocular surface abnormalities and their prevalence in ‎Rheumatoid arthritis (RA) patients and to determine the correlation between RA ‎disease activity and duration with ocular surface abnormalities and different ‎assessment parameters.‎


A prospective, cross-sectional observational study was conducted in ‎Ophthalmology outpatient clinic in collaboration with Rheumatology and ‎Rehabilitation outpatient clinic, Assiut University, Egypt from February 2014 till ‎September 2014.‎


Seventy patients with non-Sjogren RA were enrolled in our study (137 eyes). Three eyes were ‎excluded owning to previous cataract surgery. Complete ophthalmic evaluation by ‎slit lamp Biomicroscopy, Goldmann applanation tonometer and dilated fundus ‎examination was done for all patients. Ocular surface assessment included ‎Fluorescein stain, Rose Bengal stain and Schirmer test. Complete Rheumatological ‎evaluation, disease duration and RA activity by DAS.28 score (including morning ‎stiffness, SJC, TJC and ESR levels) were done. ‎


Mean age was 47.96 ± 10.8 years. Male-to-female ratio was 1:22. Mean ‎Schirmer test (ST) value was ‎10.61 ± 6.09‎ mm/5 min while mean Rose Bengal (RB) ‎score was 6.84 ± 3.59. Ocular surface evaluation revealed that 54.7% (75 eyes) have ‎dry eye, 1.45% (2 eyes) epicleritis, 13.9% (19 eyes) have corneal thinning and 8.88% ‎‎(12 eyes) have filamentary keratitis. There was a negative correlation between ST ‎and disease duration (p-value= 0.042), ST and DAS.28 (p-value= 0.208). ‎Meanwhile, there was a positive correlation between RB and disease duration (p-‎value= 0.125) and negative correlation between RB and DAS.28 score (p-‎value=0.828). ‎


Dry eye is prevalent among non-Sjogren RA patient in Egypt. There was a ‎correlation between Schirmer test, RB score, disease duration and activity but ‎without statistical significance apart from significant negative correlation between ST ‎and disease duration. We concluded that ocular surface abnormalities and dry eye ‎disease should be suspected and managed promptly in all patients of RA regardless ‎disease activity and duration.‎ Ophthalmic follow up of RA patients should also include Schirmer test and Rose Bengal Stain for early detection of ocular surface abnormalities.

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