Ocular Manifestations during Rheumatoid Arthritis in Conakry

Abstract

Rheumatoid arthritis (RA) is a systemic inflammatory disease that primarily affects the joints and may also manifest with extra-articular symptoms. Ocular involvement is common in patients with rheumatoid arthritis and may represent the main clinical manifestation of the disease. Aim: To study the epidemiological and therapeutic particularities of ocular manifestations during rheumatoid arthritis in Conakry. Material and Methods: This was a descriptive cross-sectional study of 6 months duration from 1 January to 30 June 2018 on patients with RA. All patients with chronic inflammatory rheumatism in whom the diagnosis of rheumatoid arthritis had been made according to the diagnostic criteria of the American College of Rheumatology (ACR) 2010 and these patients benefited from a complete ophthalmologic examination. Results: We enrolled 22 patients. The mean age was 43.45 ± 16.07 years (range 21 and 79 years). The mean age at onset of symptoms was 39.4 years with a mean time to diagnosis of RA of 3.9 years. Females dominated with 77.27% of cases with a sex ratio of 0.22 M/F. Photophobia (39.29%), xerophthalmia (31.82%), lacrimation and decreased vision 5 cases or 22.73 each, pruritus (9.09%), foreign body sensation and red eye with 2 cases each or 9.09% were the most frequent symptoms. The different ophthalmological diagnoses found were dry eye 19 cases or 86.36%, allergic conjunctivitis 4 cases or 18.18%, ametropia 3 cases or 13.64%, cataract 2 cases or 9.09%, superficial punctate keratitis 2 cases or 9.09% and chronic glaucoma 1 case or 4.55%. The management of dry eye was based on tear substitutes. Cataract cases (9.09%) required surgical intervention while patients with ametropia (13.04%) received optical correction. Cases of allergic conjunctivitis (18.18%) were reported. Conclusion: Good coordination between the ophthalmologist and the rheumatologist is necessary to optimize the management of patients with rheumatoid arthritis.