JOURNAL READING

Ophthalmology Research: An International

Journal

Ocular Involvement in
Patients with
Rheumatoid Arthritis
Presented
by :
Azet Mutaqin
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 INTRODUCTION
Rheumatoid arthritis

diverse and include dry eye,

Extra-articular Ocular episcleritis, scleritis &
Manifestation involvement peripheral ulcerative
keratitis

often seen in patients with RF (+) &

anti-cyclic citrullinated peptide
antibody (+)
MATERIAL AND METHODS

Examined by laboratory tests such as :

rheumatoid factor
anti-cyclic citrullinated peptide antibody

keratoconjuctivitis sicca Schirmers test

lacrimal secretion

Methotrexate 10-15 mg/week for 3 months

folic acid 10 mg/week
low doses of glucocorticoid 7.5 mg / day
non steroidal anti inflammatory drugs
MATERIAL AND METHODS

Schirmer
Schirmer test
MATERIAL AND METHODS

Exclusion Criteria
 Statistical Analysis
Data were analyzed using the

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RESULT
Ocular manifestations
13 patients (19%)

Keratoconjunct
ivitis sicca
9 patients
(13%)

Episcleritis
2 patients (3%)

Scleritis
2 patients (3%)
RESULT
 DISCUSSIONS
ocular
ocular lesions are important extra-
manifestations
were found in articular manifestations in rheumatoid
19 % of patients arthritis.
with rheumatoid
arthritis
The extraarticular complications of
rheumatoid arthritis include
ophthalmological manifestations,
This indicates : which can in some cases be the first
signs of the disease
 The most common
manifestation of ocular
Involvement :

Keratoconjunctivitis
sicca (13%)

Incidence of
the most frequent
keratoconjunctivitis
complication in
sicca is between 15%
rheumatic diseases
- 25%,
and is
particularly common
Incidence in literature
in
& in patients with
RA & Sjgren
immunological tests
syndrome
(+) is 10%
 Episcleritis & scleritis
are described in patients
with RA

Studies have shown that patients with

RA associated scleritis have more widespread
systemic disease & a higher mortality rate
than those without scleritis.
Scleritis and episcleritis in patients with RA is
found at a prevalence rate of 4-10%.

(reported to be 0.67% to 6.3%)

According to this study in patients with

rheumatoid factor & anti-cyclic citrullinated
peptide antibody positive ocular manifestations
occurred frequently in 23,8% patients versus
group of patients seronegative and we found
correlation 14
Rheumatoid factor & ant-cyclic citrullinated
peptide antibody has been shown to be
predictor of extra-articular manifestations
in RA

Our results seem to suggest that the presence

of rheumatoid factor & cyclic citrullinated
peptide antibody is associated with ocular
manifestations
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The combined presence of anti-cyclic
citrullinated peptide antibody % rheumatoid
factor severe ocular involvement compared
to those who were negative for these antibodies

This indicates that the immune system is

implicated in the development of ocular
lesions

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STUDY LIMITATIONS

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 CONCLUSION

Keratoconjunctivitis sicca, episcleritis and

scleritis are ocular manifestations that occur
in rheumatoid arthritis.
Immunological alterations are important
factors in ocular manifestations.

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Thank
You
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