Anterior segment parameters associated with extramuscular manifestations in polymyositis and dermatomyositis

Griger, Zoltán; Dankó, Katalin; Németh, Gábor; Ziad, Hassan; Aszalos, Zsuzsa; Szabó, Katalin; Bodoki, Levente; Gesztelyi, Rudolf; Zsuga, Judit; Szodoray, Péter; Kemény-Beke, Ádám

doi:10.18240/ijo.2020.09.17

Cited by 5 publications

(5 citation statements)

References 30 publications

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“…Remission of dysphagia typically occurs with the remissions of the disease. Therefore, most studies focused on reporting the treatments for DM or JDM 16,19,20,22,23,27–38 . These studies reported that patients with DM and JDM were treated with the following: (1) corticosteroids (both oral and pulse therapy) which include prednisone and methylprednisolone, (2) immunosuppressants including methotrexate, azathioprine, mycophenolate mofetil and cyclophosphamide, (3) immunomodulatory agents such as intravenous immunoglobulin therapy (IVIg) and hydroxychloroquine, and (4) biologics such as rituximab (Table 1).…”

Section: Resultsmentioning

confidence: 99%

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A systematic review and meta‐analysis on the prevalence and clinical characteristics of dysphagia in patients with dermatomyositis

Cheng

Wong

2023

Neurogastroenterology Motil

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BackgroundDermatomyositis (DM) is a rare autoimmune disease characterized by distinctive skin rash, muscle inflammation with symmetrical and progressive muscle weakness, and elevated serum levels of muscle‐associated enzymes. DM may affect skeletal muscles involved in swallowing, leading to dysphagia, which can negatively impact individual's physical and psychosocial well‐being. Despite this, dysphagia in patients with DM remains poorly understood. This systematic review and meta‐analysis aimed to evaluate the prevalence and clinical features of dysphagia in patients with DM and juvenile DM (JDM).MethodsFour electronic databases were systematically searched until September 2022. Studies with patients with DM or JDM and dysphagia were included. The pooled prevalence of all included studies was calculated, and the clinical characteristics of dysphagia were qualitatively analyzed.Key ResultsThirty‐nine studies with 3335 patients were included. The overall pooled prevalence of dysphagia was 32.3% (95% CI: 0.270, 0.373) in patients with DM and 37.7% (95% CI: −0.031, 0.785) in patients with JDM. Subgroup analyses revealed that Sweden had the highest prevalence (66.7% [95% CI: 0.289, 1.044]), whereas Tunisia had the lowest prevalence (14.3% [95% CI: −0.040, 0.326]). Moreover, South America had the highest prevalence (47.0% [95% CI: 0.401, 0.538]), whereas Africa had the lowest prevalence (14.3% [95% CI: −0.040, 0.326]). Dysphagia in patients with DM and JDM was characterized by both oropharyngeal and esophageal dysfunctions, with predominant difficulties in motility.Conclusions & InferencesOur findings showed that dysphagia affects one in three patients with DM or JDM. However, the documentation on the diagnosis and management of dysphagia in the literature is inadequate. Our results highlighted the need to use both clinical and instrumental assessments to evaluate swallowing function in this population.

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Section: Resultsmentioning

confidence: 99%

“…treatments for DM or JDM. 16,19,20,22,23,[27][28][29][30][31][32][33][34][35][36][37][38] These studies reported that patients with DM and JDM were treated with the following:…”

Section: Dysphagia Managementmentioning

confidence: 99%

A systematic review and meta‐analysis on the prevalence and clinical characteristics of dysphagia in patients with dermatomyositis

Cheng

Wong

2023

Neurogastroenterology Motil

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“…Idiopathic inflammatory myopathies do not involve only the muscles, but often also the skin, joints, and eyes (including involvement of adjacent structures, such as damage to the anterior and posterior segments) (21). The earliest report of DM-related retinopathy was the study by Bruce (22), and subsequent reports of ocular symptoms associated with DM have been published (23)(24)(25)(26).…”

Section: Introductionmentioning

confidence: 99%

Retinal microvascular and microstructural alterations in the diagnosis of dermatomyositis: a new approach

Huang

Ling

et al. 2023

Front. Med.

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PurposeTo study the relationship between fundus alterations, including retinal thickness and microvascular changes, and dermatomyositis (DM) using optical coherence tomography angiography (OCTA).MethodsA total of 16 patients with DM (32 eyes) and 16 healthy controls (HCs; 32 eyes) participated in this study. Based on the Early Treatment Diabetic Retinopathy Study subzones, OCTA fundus data were divided into different layers and regions for comparison.ResultsThe full retinal thickness (RT) in the inner nasal (IN), outer nasal (ON), inner inferior (II), and outer inferior (OI) regions of patients with DM was significantly lower than that of HCs (P < 0.001). The inner layer RT was also significantly lower in the IN, ON, II, and OI regions in patients with DM (P < 0.001). The outer layer RT was lower only in the II region in patients with DM compared to HCs (P < 0.001). The full RT of the II region was more sensitive to the pathological changes of disease since its ROC curve had an AUC of 0.9028, 95% CI: 0.8159–0.9898. Meanwhile, the superficial vessel density (SVD) of patients with DM was significantly lower in the IN, ON, II, and OI regions compared to HCs (P < 0.001). The AUC for region II was 0.9634 (95% CI: 0.9034–1.0), which indicated good diagnostic sensitivity.ConclusionOptical coherence tomography angiography can be used to evaluate relevant ocular lesions and monitor disease progression in patients with DM and interstitial lung disease.

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“…Heliotrope rash, a characteristic violaceous discoloration of eyelids in DM has been the most widely demonstrable finding. Current reports of anterior segment involvement include conjunctivitis, chemosis, iritis, glaucoma and episcleritis, ptosis of eyelids, diplopia, strabismus, and nystagmus ( 3 ). Ocular muscles in DM remain unaffected even in advanced or untreated cases.…”

Section: Introductionmentioning

confidence: 99%

“…Retinal involvement in PM and DM was first described by Bruce in 1938, followed by several case reports later on describing Purtscher-like retinopathies, unilateral retinal pigment epithelial (RPE) detachment, serous retinal detachment, cotton wool spots and optic atrophy ( 3 , 5 , 6 ). Retinopathy usually resolves completely without complications but can also lead to lasting and intense visual loss, with the development of retinal neovascularization.…”

Section: Introductionmentioning

confidence: 99%

Retinal changes in patients with idiopathic inflammatory myopathies: A case-control study in the MyoCite cohort

et al. 2022

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BackgroundRetinal changes are the window to systemic vasculature. Therefore, we explored retinal changes in patients with Idiopathic inflammatory myopathies (IIM) as a surrogate for vascular health.MethodsAdult and Juvenile IIM patients (2017 ACR/EULAR criteria), visiting a tertiary care center in 2021 were enrolled for detailed ophthalmic examination in comparison with healthy controls (HC). Patients with conditions that precluded thorough posterior chamber examination were excluded. Scale variables are expressed as median (IQR). Multivariate analysis (binary logistic regression-BLR) was conducted, adjusting for age, gender, and comorbidities besides factors significant in univariate analysis.Results43 patients with IIM [31 females; age 36 (23–45) years; disease duration 5.5 (2-12) months] were enrolled for participation. DM (44%) was the most common diagnosis. IIM patients exhibited frequent attenuation of retinal vessels (32.6 vs. 4.3%, p < 0.001), AV nicking (14 vs. 2.2%, p = 0.053), and vascular tortuosity (18.6 vs. 2.2%, p = 0.012), besides decreased visual acuity (53.5 vs. 10.9%, p<0.001) and immature cataracts (34.9 vs. 2.2%, p < 0.001). Attenuation of vessels [OR 10.9 (1.7–71), p = 0.004] emerged as significantly different from HC after adjusting for covariates in BLR. Notably, adults with IIM were more predisposed to retinal abnormalities [21 (57%) vs. 1 (16%), p = 0.068], especially attenuation of vessels [14(38%) vs. 0(0), p = 0.067] than jIIM. However, no difference was found in retinal features amongst the subtypes of adult IIM, nor did they correlate with MDAAT, MDI, or HAQ-DI.ConclusionRetinal microvasculopathy and diminution of vision occur in nearly one-thirds to half of the patients with IIM. Microvasculopathy occurs across subtypes of IIM, and more so in adults, calling for further investigation as a surrogate for damage assessment and potentially even systemic vascular health.

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Anterior segment parameters associated with extramuscular manifestations in polymyositis and dermatomyositis

Cited by 5 publications

References 30 publications

A systematic review and meta‐analysis on the prevalence and clinical characteristics of dysphagia in patients with dermatomyositis

A systematic review and meta‐analysis on the prevalence and clinical characteristics of dysphagia in patients with dermatomyositis

Retinal microvascular and microstructural alterations in the diagnosis of dermatomyositis: a new approach

Retinal changes in patients with idiopathic inflammatory myopathies: A case-control study in the MyoCite cohort

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