Ocular manifestations of rheumatic diseases: A hospital based study

Abstract

Background Changes in the organ of sight in rheumatic diseases may result from the inflammatory process because of immune mediated ocular inflammation which causes severe debilitation and visual loss. Therefore by understanding the various ocular presentations of these systemic inflammatory diseases is vital so as to arrive expeditiously at the correct diagnosis and treatment plan with the goal of preserving visual function. Methods A cross sectional study was done on patients over a period from November 2014 to September 2015. A total of 102 patients with rheumatic disease were investigated for any ocular manifestations after obtaining informed written consent. ACR(American College of Rheumatology) criteria was used for the diagnosis of Rheumatic Diseases. Ocular investigation for dry eye included Schirmer's test, Tear film break up time test (TBUT) and 1% Rose Bengal test. Positivity for Immunological factors and their association to ocular manifestations statistically analyzed. Results The overall incidence of ocular manifestations of the rheumatic disease process in the study was 63.7% (65 cases). Uveitis incidence was 34.3%(35 cases) being the commonest ocular abnormality detected followed by KCS of 19.6%(20cases). The total number of cases with ANA positivity in Rheumatic disease is 22 as in Table 4, those with ocular manifestations and ANA positivity is 16 out of 20 (80%) as in Table 5. Six (50%) of the twelve patients with Keratoconjunctivitis sicca had high Rheumatoid factor titer values by slide agglutination (≥ 1:128). Conversely of the seven patients with high Rheumatoid factor titer values (≥ 1:128), six (85.7%) had Keratoconjunctivitis sicca. Conclusion Therefore, following a multidisciplinary approach by ophthalmologists, rheumatologists, physicians and pediatrician would help for an early intervention to preserve vision where possible.