Ocular surface disorders affect quality of life in patients with autoimmune blistering skin diseases: a cross-sectional study

Abstract

Background Autoimmune blistering skin diseases (AIBD) are a group of rare chronic autoimmune diseases which are associated with ocular surface diseases especially dry eye disease. This study is designed to investigate the relationship between ocular surface disorders and quality of life among patients with autoimmune blistering skin diseases. Methods Twenty-four AIBD patients (18 pemphigus and 7 pemphigoid) and twenty-five non-AIBD controls were included. Ocular surface disease index (OSDI), ocular surface evaluation, including slit-lamp examination, Schirmer I test, tear break-up time, corneal fluorescein staining, lid-parallel conjunctival folds, meibomian gland evaluation, presence of symblepharon and corneal opacity were assessed. Life quality was evaluated by multiple questionnaires, including Medical Outcomes Study 36-Item Short Form Questionnaire (SF-36), Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI) and Health Assessment Questionnaire-Disability Index (HAQ-DI). Ocular surface tests and quality of life were compared between AIBD patients and non-AIBD controls. In the AIBD patients, the associations between ocular surface parameters and quality of life were also evaluated. Results 92% of AIBD patients and 87.5% of age- and sex-matched non-AIBD controls were diagnosed with dry eye in this study. Compared with non-AIBD controls, AIBD patients reported lower SF-36 scores (P < 0.05) and severer OSDI, Schirmer I test, tear break-up time, corneal fluorescein staining, presence of symblepharon and corneal opacity measures (P < 0.05). OSDI, Schirmer I test were correlated with SF-36 composite scores or scores on the SF-36 subscales. Conclusions AIBD patients experience reduced quality of life and more severe ocular surface disorders including dry eye, symblepharon and corneal opacity. Early treatments of dry eye and collaborations among multidisciplinary physicians are necessary in patients with AIBD.

Sleep deprivation induces corneal endothelial dysfunction by downregulating Bmal1

“…Insufficient sleep can cause various diseases, such as diabetes, obesity, and vascular diseases [ 3 ]. In the eye, previous studies have reported that sleep deprivation (SD) is a major risk factor for ocular surface diseases, such as dry eye and corneal epithelial lesions [ 4 – 7 ]. Therefore, the harm of sleep loss on ocular health has drawn the attention of ophthalmologists.…”

Ocular involvement in oral vesiculobullous diseases: A review on reported cases in the literature

“…These lesions can have important extra-oral complications, one of the most important of which is eye involvement, which can even lead to blindness. The vesiculobullous diseases previously mentioned can cause a variety of symptoms in the eye, from mild irritation and dry eye to severe vision loss, symblepharon, eyelid malposition, chronic conjunctivitis, and ocular surface scarring ( Kang et al, 2022 ).…”