Evaluation of Corneal Parameters with Scheimpflug Imaging in Patients with Rheumatoid Arthritis

Abstract

The results suggest that RA patients have thinner corneas compared to control subjects that may be affected by disease duration. Furthermore, coexistence of DE and RA seems to aggravate the thinning of cornea as well.

Corneal Involvement in Systemic Inflammatory Diseases

“…8-10 However, a study using Pentacam rotating Scheimpflug camera has demonstrated that the cornea of patients with rheumatoid arthritis is thinner than that of normal populations, and the accompanying dry eye involves an additional significant decrement in corneal thickness in these patients. 7 Accordingly, Villani et al found that the corneas of patients with rheumatoid arthritis to be significantly thinner than those of control subjects in their in vivo confocal study. They found similar corneal thickness values in patients with rheumatoid arthritis with or without secondary Sjogren syndrome.…”

“…6 The underlying mechanism of corneal thinning is believed to be due to chronic degradation of type IV collagen in the cornea by type IV collagenases produced by activated Langerhans cells. 7 Recently, a study also found a significant lower CCT in patients with another CVD-ankylosing spondylitis -when compared with aged-matched controls. 12 CCT in scleroderma has been subject to debate because of conflicting reports.…”

“…The pathology of both conditions is suggested to be a local antigen-antibody reaction that triggers a number of complex biochemical and cellular responses, including antigen-presenting cells, CD4T cells, macrophage activation with resultant secretion of proinflammatory cytokines, resulting in the lysis of the corneal collagen and corneal thinning, which explains the biomechanical findings. 7,9 Emre et al, 10 however, investigated corneal biomechanical properties in patients with scleroderma (also known as systemic sclerosis). The mean CRF and Goldmann-related IOP values of patients with scleroderma were higher than those of age-matched healthy control.…”

“…Only a few studies have investigated the corneal biomechanical properties, such as CCT and ORA parameters in CVD. [7][8][9][10][11][12] Prata et al have demonstrated abnormal corneal biomechanics in patients with rheumatoid arthritis (lower corneal hysteresis and IOP values than healthy controls). 8 Similarly, Yazici et al 9 have reported that patients with systemic lupus erythematosus present with lower corneal hysteresis, lower corneal resistance factor (CRF), and Goldmann-related IOP values compared with age-matched controls.…”

“…3 The overall understanding of corneal manifestations derived from immunologic and rheumatologic inflammatory disorders has continued to expand over the past few years, with corneal characteristics being described using histological diagnostic techniques, corneal topographic maps, in vivo confocal microscopy, ocular response analyzer (ORA) parameters, and central corneal thickness (CCT) measurements. [4][5][6][7][8][9][10][11][12] The purpose of this review is to summarize corneal abnormalities and characteristics in the setting of systemic inflammatory diseases.…”