Received: 03.08.2022; Accepted: 22.08.2022; Published on-line: 27.10.2022

Clinical manifestations of keratitis and corneal ulcers in patients with rheumatoid arthritis: a retrospective analysis

L. Y.  Riazanova,  G. I. Drozhzhyna 

SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine"; Odesa (Ukraine)

TO CITE THIS ARTICLE: Riazanova LY,  Drozhzhyna GI.  Clinical manifestations of keratitis and corneal ulcers in patients with rheumatoid arthritis: a retrospective analysis. J.ophthalmol.(Ukraine).2022;5:12-8.  http://doi.org/10.31288/oftalmolzh202251218     

Background: The prevalence of keratitis and corneal ulcers among rheumatoid arthritis (RA) patients with corneal disease is not known for certain, and the features of their clinical manifestations have been not sufficiently studied.

Purpose: To retrospectively assess the prevalence and clinical manifestations of keratitis and corneal ulcers in RA patients with corneal disease based on the medical records of patients that were hospitalized at Corneal Pathology Department of the Filatov Institute from January, 2014, through August, 2019.

Material and Methods: We have retrospectively examined the medical records of 6627 patients that were hospitalized at Corneal Pathology Department of the institute in the above period of time.

Results: Of the 6627 patients that were hospitalized, 82 (or 1.2%) were RA patients with keratitis and/or corneal ulcers. Of these 82 patients aged 37 to 79 years, 23 (28%) were men and 59 (72%) were women. Bilateral corneal lesions were found in 71 (86.6%), and unilateral corneal lesions, in 11 (13.4%) of the 82 study patients, with 153 eyes totally included in the study. Punctate or filamentary keratitis was found in 90 (58.8%) eyes. Severe corneal lesions (ulcers or keratoscleromalacia) were found in 63 (41.2%) eyes. Of the 82 RA patients with corneal lesions of the current study, 39 (47.6%) did not receive basic therapy for RA, and exhibited the most severe corneal lesions.

Conclusion: Patients with RA need to be systematically seen by an ophthalmologist and a rheumatologist. The absence of treatment with basic therapy for RA can cause ocular complications. A patient with RA needs to be treated for any corneal lesion at a tertiary care center where a required surgical procedure can be timely performed. The success of treatment for corneal lesions in a RA patient requires a set of treatment measures, and adequate basic therapy for RA is a necessary component of this set.

Keywords: keratitis, corneal ulcer, keratoscleromalacia, rheumatoid arthritis



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Corresponding Author: Riazanova LY, e-mail: lili.r@ukr.net

Athour Contribution: Riazanova L Y: Conceptualization; Data Curation; Formal Analysis; Writing – original draft; Writing – review & editing. Drozhzhyna GI: Conceptualization; Formal Analysis; Project administration;Writing – review & editing. All authors approved the final version of the manuscript and were responsible for submitting it for publication.

Disclaimer: The opinions presented in this article are those of the authors and do not necessarily represent those of their institutions.

Funding sources: No funding received

The study is a portion of Features of the Pathogenesis of Corneal Degenerative (Keratoconus), Inflammatory (Bacterial and Fungal Keratitis) and Autoimmune (Rheumatoid Arthritis, Stevens-Johnson Syndrome and Lyell's Syndrome) Disorders and Developing Novel Methods for Treating Them, a research program (Ukrainian State Registration No. 0119U103094).

Conflict of interest: The authors state that they have no conflict of interest that might bias this work.

Subjects: The study involved human subjects, was approved by the Ethics Committee, and adhered to the tenets of the Declaration of Helsinki. Informed consent was not obtained due to the retrospective nature of the study.

Abbreviations: CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; IOP, intraocular pressure; RA, rheumatoid arthritis; WHO, World Health Organization