Ocular Manifestations of Rheumatoid Arthritis: Implications of Recent Clinical Trials

Abstract

The variation in the reported rates of KCS can be attributed to factors such as: limited sample size, age of patients sampled, gender, subjective versus objective determination of DED. The association between RA and KCS is well established and contributes to morbidity [4][5][6]. Features and pathogenesisSymptoms of KCS include: burning, gritty sensation and dryness. A recent meta-analysis demonstrated a link between dry eye disease and depression and anxiety [7]. If left untreated, KCS may lead to a lidwiper epitheliopathy (analogous to that found in long-term contact lens wearer), keratitis, and possibly even opacification of the cornea [8]. In severe cases, one can see paracentral corneal melts which can cause permanent visual loss, and even perforation.Inflammation has been postulated as the underlying cause for KCS [9]. The pathogenesis of RA involves an inappropriate attack on the

Endothelial Dysfunction and Extra-Articular Neurological Manifestations in Rheumatoid Arthritis

“…Frequently, eye damage can worsen and turn into chronic conjunctivitis or corneal ulcers [ 53 ]. Inflammatory ophthalmological conditions include episcleritis, scleritis, and peripheral ulcerative keratitis and can greatly exacerbate ocular prognosis as they aggravate RA conditions and increase the risk of developing systemic vasculitis [ 54 ]. For this reason, at the time of the diagnosis of RA, there should be a close collaboration between the rheumatologist and the ophthalmologist.…”

Multinodular scleritis in a patient with rheumatoid arthritis

“…Scleritis is a rare extra articular manifestation of RA (0.2 to 6.3%) [1]. It tends to occur in patients with severe disease [2].…”

“…The two main types of anterior scleritis are necrotizing and nonnecrotizing scleritis, which can be diffuse or nodular [2]. Nodular scleritis has been reported in 20% of cases.…”

“…Immunosuppressive agents are the first-line treatment for scleritis in patients with RA [2]. Adalimumab has been previously reported to be effective in patients who are unable to receive conventional treatment [3].…”

Low-Concentration (0.66%) Povidone Iodine Treatment of a Corneal Ulcer in a Rheumatoid Arthritis Patient

“…This autoimmune and chronic inflammatory systemic disease, in fact, involves extra-articular complications that include ophthalmological manifestations, sometimes representing the first signs of the pathology. RA is often linked to episcleritis, scleritis, keratoconjunctivitis sicca, peripheral ulcerative keratitis (PUK), anterior uveitis, and retinal vasculitis [ 4 , 5 ]. Any component of the eye can be affected in RA, as the damage of the ocular tissues is autoimmune mediated [ 6 ].…”