Dry Eye Disease in Routine Rheumatology Practice

Ziaragkali, Sevastiani; Kotsalidou, Aggeliki; Trakos, Nikolaos

doi:10.31138/mjr.29.3.127

Cited by 10 publications

(6 citation statements)

References 35 publications

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“…There is a well-known association of dry eye with rheumatic disease severity like pSS, RA, and SLE. 11 Dry eye results in a significant increase in costs which falls on individual medication and health service and marks adverse financial consequences for economy. 12 Likewise, dry eye has a devastating effect upon patients’ quality of life.…”

Section: Discussionmentioning

confidence: 99%

Elevated Rheumatoid Factor Associates with Dry Eye in Patients with Common Autoimmune Diseases

Zhao¹,

Xiao²,

Zhang³

et al. 2022

JIR

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Purpose To investigate the association and application value of rheumatoid factor (RF) in diagnosis of dry eye among patients with common autoimmune diseases. Patients and Methods A retrospective case-control study was conducted from Jan 1st 2019 to Dec 31st 2020, and 117 patients with common autoimmune diseases were enrolled. The concentrations of serum RF were detected. The receiver operating characteristics (ROC) curve was plotted to evaluate the values of RF in diagnosis. Results Compared with no dry eye patients, patients with dry eye (n = 59, 50.43%) had higher levels of RF ( P < 0.001). Moreover, Pearson’s correlation analysis showed that RF levels were negatively correlated with Schirmer-I tear test ( P = 0.004) and invasive tear film break-up time ( P = 0.002), respectively. The statistically significant threshold value (cut-off points) of the RF levels for dry eye was 21.4 (IU/mL), and the areas under the curve (AUC) of RF was 0.73 (95% confidence interval [CI]: 0.639–0.821; P < 0.001) (sensitivity = 78%; specificity = 58.6%) for dry eye among patients with common autoimmune diseases. Conclusion Serum levels of RF may be an independent factor for dry eye among patients with common autoimmune diseases, and they may have a high significant value and clinical application value.

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Section: Discussionmentioning

confidence: 99%

Elevated Rheumatoid Factor Associates with Dry Eye in Patients with Common Autoimmune Diseases

Zhao¹,

Xiao²,

Zhang³

et al. 2022

JIR

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“…to the special structure of the blood-ocular barrier [43], topical pharmacotherapy is more important than systemic immunosuppressant therapy in ARDs-related dry eye, such as arti cial tears, autologous serum eye drops, corticosteroid eye drops, even immunosuppressant eye drops [44].…”

Section: Declarations Fundingmentioning

confidence: 99%

Evaluation of ocular surface involvement and systemic conditions in patients with autoimmune rheumatic diseases

Liu

Ren

et al. 2023

Preprint

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Purpose: To evaluate and explore the ocular surface involvement and systemic conditions in autoimmune rheumatic diseases (ARDs). Methods: 79 patients with ARDs were enrolled in our study, including 26 patients with rheumatoid arthritis (RA), 33 patients with systemic lupus erythematosus (SLE), and 20 patients with primary Sjögren’s syndrome (pSS). All patients underwent ocular surface evaluation, including ocular surface symptoms and signs, conjunctival impression cytology, and tear multi-cytokine detection. The systemic conditions were also collected, including disease duration and disease activity. Results: SLE patients have the shortest disease duration and nearly half of them have low disease activity, while RA patients and pSS patients have a relatively long disease duration and about 90% of them have moderate/high disease activity. The incidence of dry eye and the levels of pro-inflammatory tear cytokine in SLE patients is significantly lower than RA and pSS patients, while there was no significant difference between RA and pSS patients. However, pathologic squamous metaplasia on the ocular surface is more severe in SLE and pSS patients than RA patients. Dry eye severity in all ARDs patients was shown independent of disease activity, while the ocular surface Nelson’s grades are positively correlated with disease duration in RA patients. Conclusions: Dry eye and ocular surface inflammation persist in most ARDs patients, and do not occur in parallel with the disease activity. Other than pSS, dry eye and ocular surface squamous metaplasia also exist in SLE and RA. Therefore, all patients with ARDs require a regular ophthalmologic evaluation and topical medications.

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“…Inclusion criteria for studies were as follows: (a) study groups included participants with DM, including type 1 DM, type 2 DM, GDM, and unclassified DM, and the control groups included participants without DM; (b) study outcome assessments used common tests to assess DED severity (15); and (c) study designs were cohort, case-control, or crosssectional. We excluded studies in which (a) study or control groups focused on non-human participants; (b) study participants had Graves' disease, connective tissue disorders, chronic kidney disease, or other autoimmune diseases (as autoimmune diseases disturb lacrimal secretion and dialysis alters tear quality) (16,17); (c) study participants had a medical history of corneal disease, glaucoma, contact lens wearing, current use of ocular medication, or previous intraocular surgery (as structural damage to the cornea and eye drops interrupt tear secretion); (d) the literature was gray (e.g., conference abstracts) without detailed information on participants' baseline characteristics, risk of bias evaluation, or results extraction; (e) data reports were duplicated (from the same source population); and (f) the language of publication was not English.…”

Section: Eligibility Criteria For Study Selectionmentioning

confidence: 99%

Tear function in patients with diabetes mellitus: A systematic review and meta-analysis

Kuo

Shao²,

Lin³

et al. 2022

Front. Endocrinol.

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PurposeTo examine tear function in patients with diabetes mellitus (DM).DesignSystematic review and meta-analysis.MethodWe searched Embase and PubMed from database inception to March 16, 2022. We included observational studies that compared tear function between patients with and without DM. Tear function was measured using invasive tear breakup time (ITBUT) and Schirmer’s 1 test. Pooled results are presented as standard mean difference (SMD) with 95% confidence interval (CI) based on random-effects models.ResultsWe included 59 studies (7,234 eyes) comparing the tear function between patients with and without DM. This meta-analysis indicated that patients with DM had worse tear function than those without DM (ITBUT: SMD: −0.98, 95% CI: −1.27 to −0.69; Schirmer’s 1 test: SMD: −0.45, 95% CI: −0.64 to −0.26), and the results remained consistent in patients with different types of DM (e.g., type 1 DM and type 2 DM) and from different ethnic backgrounds (e.g., Asian vs. non-Asian). Patients with DM under poor glycemic control had worse tear function than those of the non-DM group (ITBUT: SMD: −1.26, 95% CI: −1.86 to −0.66; Schirmer’s 1 test: SMD: −0.25, 95% CI: −0.48 to −0.02), whereas there were no significant differences in tear function between patients with DM under optimal glycemic control and non-DM groups.ConclusionsWe found that patients with type 1 or type 2 DM had significantly reduced tear function. The level of tear function could be determined by glycemic control, and therefore, our findings suggest that glycemic control in patients with DM is critical for maintaining tear function.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero, identifier CRD42021250498.

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Dry Eye Disease in Routine Rheumatology Practice

Cited by 10 publications

References 35 publications

Elevated Rheumatoid Factor Associates with Dry Eye in Patients with Common Autoimmune Diseases

Elevated Rheumatoid Factor Associates with Dry Eye in Patients with Common Autoimmune Diseases

Evaluation of ocular surface involvement and systemic conditions in patients with autoimmune rheumatic diseases

Tear function in patients with diabetes mellitus: A systematic review and meta-analysis

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