Rheumatoid Arthritis Associated with Dry Eye Disease and Corneal Surface Damage: A Nationwide Matched Cohort Study

Lai, Shih-Chung; Wang, Chien-Wun; Wu, Yu-Ming; Dai, Ying‐Xiu; Chen, Tzeng Ji; Wu, Hsiang-Ling; Cherng, Yih-Giun; Tai, Ying Hsuan

doi:10.3390/ijerph20021584

Cited by 4 publications

(4 citation statements)

References 40 publications

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“…Some studies on Sjogren syndrome and Rheumatoid arthritis reported the prevalence of dry eye about 23 per 1000 person-years. 10,11 MS disease pathogenesis has integral parts of the inflammatory cytokines secreted by Th1 and Th17, resulting in increased blood-brain barrier permeability to monocytes and macrophages. Th1 cells are found in damaged parts of the CNS and are actively present in MS patients' bloodstream, which produces inflammatory cytokines.…”

Section: Discussionmentioning

confidence: 99%

Frequency of dry eye syndrome in patients with multiple sclerosis: A cross-sectional case-control study

Sorkhabi,

Khavandi,

Ayromlou

et al. 2024

J Res Clin Med

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Introduction: Demyelination of the nerve fibers of the central nervous system is a main pathology of multiple sclerosis (MS), in which inflammation plays a major role. Studies have shown that inflammation is the leading cause of dry eye disorder. To investigate the association between inflammation and both diseases, we aimed to estimate the prevalence of dry eye syndrome (DES) in MS patients and its correlation with the severity of the disease and disability status. Methods: We enrolled 100 MS patients randomly and 100 healthy controls. DES was evaluated by Dry Eye questionnaire and Scoring System (DESS), tear break-up time (TBUT), tear meniscus height (TMH), and Schirmer 1 & 2 tests in subjects. Furthermore, the leading disability in MS was assessed by a clinician (neurology professor) using the related questionnaire (Expanded Disability Status Scale). Results: According to the TBUT, THM, and Schirmer tests, the number of subjects with abnormal results was significantly higher in the MS group than in the control group. The severity of DES measured by the DESS was also higher in the MS group compared to control group. Also, there was a significant relationship between increasing disability and abnormal dry eye tests, especially in MS patients with EDSS scores>4. Conclusion: The present study highlights the importance of considering dry eye disorder in MS patients as a possible consequence of inflammation. Also, our results suggested a significant relationship between dry eye disorder and the EDSS scores.

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Section: Discussionmentioning

confidence: 99%

Frequency of dry eye syndrome in patients with multiple sclerosis: A cross-sectional case-control study

Sorkhabi,

Khavandi,

Ayromlou

et al. 2024

J Res Clin Med

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“…This study investigated one of the extra-articular manifestations of RA potentially involving the eyes. Common ocular presentations of RA include corneal inflammation, lacrimal gland dysfunction, and uveitis, sharing similar pathogenic mechanisms to DED [ 28 , 29 ]. It was used in diagnosis and evaluating DED severity and its correlation with RA disease activity and duration, which was found to be a valuable tool as used previously in different diseases [ 30 – 33 ].…”

Section: Discussionmentioning

confidence: 99%

Non-contact meibography changes according to disease activity in rheumatoid arthritis cases

Mounir,

Anbar,

Awny

et al. 2023

BMC Ophthalmol

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Purpose To measure dry eye disease (DED) activity in rheumatoid arthritis (RA) patients, correlate it with the activity and duration of RA, and objectively measure the degree extent of DED in RA active cases. Methods The paper studied the meibomian gland of 30 RA cases referred by the Rheumatology Department, Sohag University Hospitals to Sohag Cornea and Refractive Center, Sohag, Egypt, by infrared non-contact meibography in the Scheimpflug topographer (Sirius, CSO, Italy) from July 2021 to July 2022. The cases fulfilled the RA classification criteria according to the 2010 American College of Rheumatology and European League and underwent full lab investigations. They were distributed to two groups based on the DAS-28 questionnaire. The patients were distributed into low to moderate activity (3.2 < score < = 5.1) and high activity groups (score > 5.1). Results This study included 60 eyes of 30 RA patients. They scored a mean age of (44 ± 10 years), number of swollen joints (3 ± 3), number of tender joints (5 ± 3), duration of disease (8 ± 4), activity of the disease measured by DAS-28 (4.4 ± 0.9), and sex (males were 9.7% vs females 90.3%). The number of swollen joints, tender joints, ESR and DAS-28 were more in the high activity group with the p-value of (0.018, 0.001, < 0.003 and < 0.004), respectively. There are no statistically significant differences between both groups as regards disease duration (p-value of 3.8). The high activity group showed significant affection regarding the mebioscore of the lower and upper lids, total mebioscore, percentage of meibomian glands in upper and lower lids, first non-invasive break-up time test (NIV-BUT) of the tear film, as well as average non-invasive break-up time test (NIavg-BUT). There were moderate correlations between the activity of the disease represented by (DAS-28) and different parameters evaluating eye dryness (meiboscore of the lower and upper lids, total meiboscore, percentage of meibomian glands in upper and lower lids, NIV-BUT of the tear film, and NIavg-BUT of the tear film). Conclusion There was no correlation with duration of RA but moderate correlations between the activity of the disease represented by (DAS-28) and different parameters evaluating eye dryness in RA patients with valuable use of noncontact Meibography to evaluate eye dryness in RA cases. Both Meiboscore and Meiboscale of Non-contact Meibography were found to be useful tools in grading of dry eye disease in different activity grades of Rheumatoid Arthritis.

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“…The NHI research database contains comprehensive claims data of the insured beneficiaries, including demographic characteristics (e.g., date of birth and sex), medical diagnoses, prescription drugs, and medical expenditures. The NHI research database has been widely used for public health statistics and risk assessment [19][20][21].…”

Section: Data Sourcementioning

confidence: 99%

Systemic Lupus Erythematosus and Risk of Dry Eye Disease and Corneal Surface Damage: A Population-Based Cohort Study

Tseng

Tai

Hong

et al. 2023

IJERPH

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Systemic lupus erythematosus (SLE) potentially involves multiple parts of the ocular system, including the lacrimal glands and the cornea. The present study sought to assess the risk of aqueous-deficient dry eye disease (DED) and corneal surface damage in patients with SLE. We conducted a population-based cohort study using Taiwan’s National Health Insurance research database to compare the risks of DED and corneal surface damage between subjects with and without SLE. Proportional hazard regression analyses were used to calculate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for the study outcomes. The propensity score matching procedure generated 5083 matched pairs with 78,817 person-years of follow-up for analyses. The incidence of DED was 31.90 and 7.66 per 1000 person-years in patients with and without SLE, respectively. After adjusting for covariates, SLE was significantly associated with DED (aHR: 3.30, 95% CI: 2.88–3.78, p < 0.0001) and secondary Sjögren’s syndrome (aHR: 9.03, 95% CI: 6.86–11.88, p < 0.0001). Subgroup analyses demonstrated that the increased risk of DED was augmented among patients with age < 65 years and female sex. In addition, patients with SLE had a higher risk of corneal surface damage (aHR: 1.81, 95% CI: 1.35–2.41, p < 0.0001) compared to control subjects, including recurrent corneal erosion (aHR: 2.98, 95% CI: 1.63–5.46, p = 0.0004) and corneal scar (aHR: 2.23, 95% CI: 1.08–4.61, p = 0.0302). In this 12-year nationwide cohort study, we found that SLE was associated with increased risks of DED and corneal surface damage. Regular ophthalmology surveillance should be considered to prevent sight-threatening sequelae among patients with SLE.

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Rheumatoid Arthritis Associated with Dry Eye Disease and Corneal Surface Damage: A Nationwide Matched Cohort Study

Cited by 4 publications

References 40 publications

Frequency of dry eye syndrome in patients with multiple sclerosis: A cross-sectional case-control study

Frequency of dry eye syndrome in patients with multiple sclerosis: A cross-sectional case-control study

Non-contact meibography changes according to disease activity in rheumatoid arthritis cases

Systemic Lupus Erythematosus and Risk of Dry Eye Disease and Corneal Surface Damage: A Population-Based Cohort Study

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