Ocular surface findings in patients with rheumatoid arthritis under methotrexate or biological agent therapy

Cutan Ocul Toxicol. 2017 Mar;36(1):48-51. doi: 10.3109/15569527.2016.1144193. Epub 2016 Feb 16.

Abstract

Purpose: To evaluate the ocular findings in patients with rheumatoid arthritis (RA) treated with disease-modifying antirheumatic drugs (DMARDs) such as methotrexate (MTX) or MTX with biological agents.

Methods: One hundred and twelve eyes of 56 patients with RA and treated with MTX or MTX with biological agents were included in the study. Patients were divided into two groups using DMARDs only (group 1) and patients using DMARDs and biologic agents together (group 2). In both groups; Schirmer's II test, tear film break-up time (tBUT), central corneal thickness (CCT), corneal volume (CV), intraocular pressure (IOP) measurement, and anterior segment and fundus examinations of the eye with slit lamp were carried out. Ocular surface disease index (OSDI) score questionnaire were performed.

Results: Thirty-eight patients with a mean age of 53.00 ± 8.19 years were in group 1 and 18 patients with a mean age of 51.00 ± 9.54 years were in group 2. The mean duration of RA was 6.89 ± 7.96 years in group 1 and 5.70 ± 9.00 years in group 2. There was a statistically significant difference between two groups with tBUT, CCT, CV, IOP (p < 0.05) and there was no significant difference with age, sex, disease duration, disease activity, and Schirmer's II test (p > 0.05). The disease duration showed a significant moderate negative correlation with CCT and CV in group 2 (p < 0.05).

Conclusions: Although tBUT values were significantly higher in the combination treatment group, CCT and CV values were significantly lower. Due to the decrease in corneal thickness, IOP was determined to be significantly lower.

Keywords: Biological agents; Schirmer’s II test; break-up time; corneal thickness; corneal volume; disease-modifying antirheumatic drugs; ocular surface disease index; rheumatoid arthritis.

Publication types

  • Clinical Study

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antirheumatic Agents / adverse effects*
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / drug therapy
  • Arthritis, Rheumatoid / pathology
  • Arthritis, Rheumatoid / physiopathology
  • Biological Factors / adverse effects*
  • Biological Factors / therapeutic use
  • Corneal Pachymetry
  • Eye / drug effects*
  • Eye / pathology
  • Eye / physiopathology
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Indomethacin / therapeutic use
  • Intraocular Pressure / drug effects
  • Male
  • Methotrexate / adverse effects*
  • Methotrexate / therapeutic use
  • Middle Aged
  • Tears / drug effects
  • Tears / physiology
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antirheumatic Agents
  • Biological Factors
  • Glucocorticoids
  • Tumor Necrosis Factor-alpha
  • Indomethacin
  • Methotrexate