Reduced Corneal Sensitivity in Patients With Rheumatoid Arthritis

Kim, In Geun; Lee, Ji Hyun; Kim, Sang Soo

doi:10.1097/ico.0b013e31824d0e22

Cited by 8 publications

(11 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…studies have not found statistically significant correlations between the OSDI score and corneal or conjunctival sensitivity, and the reported correlations are not consistently positive or negative. 19,24,32 One study 33 did report a significant negative correlation; however, the esthesiometer used and the areas of the ocular surface tested were different from those of this study. A study by Golebiowski et al 26 found that as lid margin sensitivity reduced, the meibomian gland dysfunction score increased.…”

Section: Discussioncontrasting

confidence: 73%

“…Some studies show a statistically significant correlation, 24,33 whereas others do not. 19,34 Even the correlation direction is not consistent. Two studies, which used Cochet-Bonnet esthesiometers, showed that as sensitivity decreases, tear breakup times decrease.…”

Section: Discussionmentioning

confidence: 92%

“…Two studies, which used Cochet-Bonnet esthesiometers, showed that as sensitivity decreases, tear breakup times decrease. 19,24 However, these studies used the traditional fluorescein technique, which may account for the variation in results. Another study used a noncontact Belmonte esthesiometer, which uses a stream of air to illicit mechanical stimulation of the cornea and a noninvasive tear breakup time similar to that used in the present study.…”

Section: Discussionmentioning

confidence: 97%

“…16 These findings have been supported by studies that have shown that subjects with neurodegenerative conditions or diabetes have reduced sensitivity and compromised dry eye tests such as tear breakup time and Schirmer test when compared with control subjects. [17][18][19] In addition, a group of subjects with rheumatoid arthritis had reduced corneal sensitivity and Schirmer strip results and worse symptoms based on the ocular surface disease index questionnaire (OSDI) compared with control subjects. 19 Another study, which classified subjects based on symptoms and Schirmer strip results, found a statistically significant difference between corneal and bulbar conjunctival mechanical thresholds in subjects with dry eye compared with normal subjects.…”

mentioning

confidence: 99%

“…[17][18][19] In addition, a group of subjects with rheumatoid arthritis had reduced corneal sensitivity and Schirmer strip results and worse symptoms based on the ocular surface disease index questionnaire (OSDI) compared with control subjects. 19 Another study, which classified subjects based on symptoms and Schirmer strip results, found a statistically significant difference between corneal and bulbar conjunctival mechanical thresholds in subjects with dry eye compared with normal subjects. 20 With this background, one could easily question whether the sensations at the ocular surface influence meibomian gland secretion and/or the quality of meibum produced.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Association Between Meibomian Gland Testing and Ocular Surface Sensitivity

Cox

Nichols²

2015

Cornea

View full text Add to dashboard Cite

show abstract

Section: Discussioncontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 97%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Association Between Meibomian Gland Testing and Ocular Surface Sensitivity

Cox

Nichols²

2015

Cornea

View full text Add to dashboard Cite

show abstract

TFOS DEWS II pain and sensation report

et al. 2017

View full text Add to dashboard Cite

Pain associated to mechanical and chemical irritation of the eye surface is mediated by trigeminal ganglia mechano- and polymodal nociceptor neurons while cold thermoreceptors detect wetness and reflexly maintain basal tear production and blinking rate. These neurons project into two regions of the trigeminal brain stem nuclear complex: ViVc, activated by changes in the moisture of the ocular surface and VcC1, mediating sensory-discriminative aspects of ocular pain and reflex blinking. ViVc ocular neurons project to brain regions that control lacrimation and spontaneous blinking and to the sensory thalamus. Secretion of the main lacrimal gland is regulated dominantly by autonomic parasympathetic nerves, reflexly activated by eye surface sensory nerves. These also evoke goblet cell secretion through unidentified efferent fibers. Neural pathways involved in the regulation of Meibonian gland secretion or mucins release have not been identified. In dry eye disease, reduced tear secretion leads to inflammation and peripheral nerve damage. Inflammation causes sensitization of polymodal and mechano-nociceptor nerve endings and an abnormal increase in cold thermoreceptor activity, altogether evoking dryness sensations and pain. Long-term inflammation and nerve injury alter gene expression of ion channels and receptors at terminals and cell bodies of trigeminal ganglion and brainstem neurons, changing their excitability, connectivity and impulse firing. Perpetuation of molecular, structural and functional disturbances in ocular sensory pathways ultimately leads to dysestesias and neuropathic pain referred to the eye surface. Pain can be assessed with a variety of questionaires while the status of corneal nerves is evaluated with esthesiometry and with in vivo confocal microscopy.

show abstract

Corneal Involvement in Systemic Inflammatory Diseases

Gomes

Santhiago

Jorge³

et al. 2015

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

View full text Add to dashboard Cite

Corneal involvement in patients with systemic inflammatory disorders may be sight threatening, and it may be associated with a life-threatening disease. Significant systemic inflammatory diseases in this context are autoimmune connective tissue diseases, systemic autoimmune dermatological disorders, and autoimmune diseases of the lacrimal system. Keratoconjunctivitis sicca is usually the most common ocular finding in these patients. Peripheral ulcerative keratitis is a rare condition usually associated with increased ocular morbidity and also mortality, as it might act as an indicator of a more widespread vasculitis. Corneal biomechanical properties may also be altered in connective tissue diseases. Although recent studies suggest that the risk for corneal complications after ocular surgery in patients with quiescent autoimmune disease is minimal, caution is still recommended, as the knowledge about the corneal wound-healing process and the corneal biomechanical properties in these patients is not yet fully understood. This article reviews corneal abnormalities and characteristics in the setting of systemic inflammatory diseases.

show abstract

Reduced Corneal Sensitivity in Patients With Rheumatoid Arthritis

Abstract: Corneal sensitivity was reduced in RA patients but failed to show any association with the subjective symptoms and objective signs of dry eyes. We could assume that reduced corneal sensitivity does not represent a sign of inflammation.

Cited by 8 publications

References 24 publications

Association Between Meibomian Gland Testing and Ocular Surface Sensitivity

Association Between Meibomian Gland Testing and Ocular Surface Sensitivity

TFOS DEWS II pain and sensation report

Corneal Involvement in Systemic Inflammatory Diseases

Contact Info

Product

Resources

About