Dry eye syndrome symptoms in patients with psoriasis

Julia Nowowiejska; Agata Joanna Ordon; Anna Baran; Justyna Izdebska; Bartosz Woźniak; Tomasz W Kaminski; Jacek Szaflik; Iwona Flisiak

doi:10.1111/jdv.19773

Dry eye syndrome symptoms in patients with psoriasis

J Eur Acad Dermatol Venereol. 2023 Dec 22. doi: 10.1111/jdv.19773. Online ahead of print.

Authors

Julia Nowowiejska¹, Agata Joanna Ordon^{2

3}, Anna Baran¹, Justyna Izdebska², Bartosz Woźniak², Tomasz W Kaminski⁴, Jacek Szaflik², Iwona Flisiak¹

Affiliations

¹ Department of Dermatology, Medical University of Bialystok, Białystok, Poland.
² Department of Ophthalmology, Independent Public University Eye Hospital, Medical University of Warsaw, Warsaw, Poland.
³ Department of Binocular Vision Pathophysiology and Strabismus, Medical University of Lodz, Lodz, Poland.
⁴ Pittsburgh Heart, Lung and Blood Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

PMID: 38140772
DOI: 10.1111/jdv.19773

Abstract

Background: Psoriasis is one of the most common dermatoses associated with a variety of comorbidities. There have been some reports on its possible association with ocular disorders however dry eye syndrome (DES) in such patients has been poorly investigated.

Objectives: To investigate the frequency of DES symptoms in psoriatic patients, also regarding psoriasis severity in PASI, manifestation and therapy.

Methods: 40 patients with psoriasis and 40 volunteers without dermatoses were enrolled in the study. They completed Ocular Surface Disease Index (OSDI) questionnaire and were objectively examined by IDRA® device to perform automatic interferometry, automatic meibography of lower eyelid glands, non-invasive break-up time (NIBUT), blink quality and tear meniscus height.

Results: Patients with psoriasis had statistically significantly thicker lipid layer (p = 0.0042 left eye, p = 0.0313 right eye) and greater loss of Meibomian glands compared to controls (p = 0.0128 left eye, p = 0.048 right eye). The patients had lower, although insignificantly, eye blink quality and tear meniscus height than the control group, as well as shorter NIBUT and higher score in OSDI. After the division of patients into two groups-with or without nails involvement/psoriatic arthritis/systemic treatment- we did not observe any significant differences between the groups. PASI did not correlate with any DES parameter.

Conclusions: This is the first study of DES symptoms with an objective IDRA® analyzer. We managed to observe that patients with psoriasis have thicker lipid layer and higher Meibomian glands' loss in lower eyelids. Based on all assessed objective and subjective parameters psoriatics do not seem to have an increased risk of DES. The presence of psoriatic arthritis or nail involvement does not seem to be a predisposing factor for DES development. PASI probably cannot be a prognostic factor for any of the DES-associated parameters. Nevertheless, DES in psoriasis requires further research on bigger samples to establish reliable recommendations.