Prevalence of ocular manifestations in systemic sclerosis patients

Abstract

IntroductionSystemic sclerosis (scleroderma, SSc) is a severe chronic connective tissue disease caused by immune system disorders and changes in the structure and functions of blood vessels, which consequently leads to enhanced tissue fibrosis. The aim of the study was to evaluate changes in the organ of vision in systemic sclerosis patients.Material and methodsOverall the study involved 27 patients with systemic sclerosis. The control group comprised 27 age- and gender-matched healthy individuals. All the study subjects underwent complete ophthalmological examination that in systemic sclerosis patients additionally involved fluorescein angiography.ResultsOphthalmological examination revealed higher incidence of the following abnormalities in the study group, compared to the control: symptoms of dry eye syndrome (19 eyes, p < 0.02), astigmatism(in 30 eyes, p < 0.01), posterior subcapsular cataract (10 eyes, p < 0.05), increased intraocular pressure (> 21 mm Hg were observed in 11 eyes, p < 0.002) and vascular abnormalities within fundus in fluorescein angiography (20 eyes).ConclusionsIn patients with systemic sclerosis numerous abnormalities within the vision of organ may be found. Regular ophthalmological examinations are essential among the mentioned group. The examination should be particularly focused on the presence of retinal vascular abnormalities.

Ocular Manifestations of Systemic Sclerosis:A Descriptive CrossSectional Study from Iraq

“…Up to the best of our knowledge, this the first report that assessed the prevalence and characteristics of ocular manifestation in Iraqi patients with SSc.The most frequently identified ocular manifestation in this study group was dry eye symptoms (74%). Dry eye syndrome is believed to be caused by fibrosis-related impairment of lacrimal gland secretion, namely water portion of the tear film or lipid layer disorder due to chronic blepharitis and Meibomian gland dysfunction, as well as increased evaporation of tears from the ocular surface in the case of restricted eyelid mobility and thus reduced blinking [20]. This finding is comparable with previous studies that showed 34.6-72% of patients with SSc have ocular symptoms [21,22].…”

“…Similarly, other studies have reported variable prevalence of eyelid changes ranged from 29 to 65% of patients [5,24]. In this study, Telangiectasia was observed in 36% of patients which is lower than that found in Gomes et al study (51.1 %) [25]. This may be due to different in sample size.…”

“…Indeed, the association between SSc and uveitis is rare, and only single case has been reported in the peer-reviewed literature [27]. Also Waszczykowska et al [26] found one patient had a history of past recurrent uveitis.Retinal microvascular abnormality was noted in only one patient (2%) whereas it was found in 13 patients (28.9%) in another study [25]. This disagreement may be due to inter-observers' variations and difference in demographic features of the study population.…”

“…Conjunctival abnormality was observed in 8% of our patients (4% had segmented tortuous conjunctival vessels and 4% had allergic conjunctivitis) whereas another study [25] found conjunctival vascular congestion (8.9%) and a loss of fine conjunctival vessels (4.4%). This disagreement may be due to sample size and differences in genetic and environmental factors between the two populations.…”

“…Significant increase of corneal thickness occurs in early stages of SSc. In Gomes et al (25) study, astigmatism was present in 2.2% of patients. Another study done by Waszczykowska A et al [26] demonstrated that astigmatism occurred in over half of the eyes and was significantly more commonly than in the control group.…”