Correlation of Retinal Sensitivity in Psoriasis and Psoriatic Arthritis with Tumour Necrosis Factor Alpha and Pigmented Epithelium Derived Factor

Abstract

Background: Early recognition is crucial because the natural course of psoriasis (Ps) may result in vision loss. Psoriatic arthritis (PsA) patients with ophthalmological manifestations of psoriasis (Ps) account for 30% of cases. Assessment of visual functions and correlation with blood levels of tumour necrosis factor-alpha (TNF-α) and pigmented epithelium derived factor (PEDF) were the study's main goals in Ps and PsA patients. Objectives: to assess visual functions in Ps and PsA patients and correlate them with serum levels of tumour necrosis factor-alpha (TNF-α) and Pigmented Epithelium Derived Factor (PEDF). Subjects &Methods: This case-control study involved 60 Ps patients, 30 of whom had Ps without arthritis and 30 of whom had PsA, 30 age and sex-matched healthy individuals were included, representing the control group. Serum levels of both TNF-α and PEDF were measured by enzyme-linked immune sorbent assay and complete ophthalmological examination of the anterior and posterior segment by slit-lamp Biomicroscopy, best corrected visual acuity, intraocular pressure, and visual field using automated perimetry. Results: Visual affection in PsA patients was affected more than psoriatic patients with positive correlation with serum TNF-α level and negative correlation with PDF. High statistically significant increase in serum TNF-α level with the severity of both Ps and PsA P= 0.000. Also, high statistically significant increase in mean deviation (MD) and increase the negativity of PSD. High statistically significant increase in TNF and decrease in PEDF levels were found between patients and control (p = 0.001) with a higher significant difference (p =0.000) in PsA patients Conclusion: To prevent vision impairment, patients with Ps and PsA should receive routine ophthalmological tests to evaluate their visual functions and spot potential ocular involvement.