Daguano Carolina Rottili, Bochnia Claudia Regina, Gehlen Marcelo
Departamento de Oftalmologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brasil.
Arq Bras Oftalmol. 2011 Mar-Apr;74(2):132-3. doi: 10.1590/s0004-27492011000200014.
Rheumatoid arthritis is the most common collagenosis and affects almost 0.6% of Brazilian population. It is an important cause of articular deformities. The main ocular manifestation of rheumatoid arthritis is dry eyes (secondary Sjögren's syndrome), followed by scleritis, peripheral ulcerative keratitis and uveitis. The aim of this paper is to present a case of anterior uveitis in the absence of scleritis in a patient with rheumatoid arthritis, a very rare presentation in this type of patient. Female patient, 55 years old, with rheumatoid arthritis, presenting suddenly ocular pain and low vision in the right eye. Her exam showed anterior chamber reaction with hypopion, peripheral corneal keratitis and intraocular pressure of 32 mmHg. She was diagnosed with hypertensive anterior uveitis and peripheral corneal keratitis and treated with systemic and topical corticosteroids, topical antibiotic, topic and systemic ocular hypotensive and mydriatic drops. Anterior uveitis is common in rheumatological diseases, especially in those seronegative arthropathies related to HLA B27. In this paper we present a patient with rheumathoid arthritis and anterior uveitis in the absence of scleritis, a rare presentation in actual medical literature.
类风湿性关节炎是最常见的胶原病，影响着近0.6%的巴西人口。它是关节畸形的一个重要原因。类风湿性关节炎的主要眼部表现是干眼症（继发性干燥综合征），其次是巩膜炎、周边溃疡性角膜炎和葡萄膜炎。本文的目的是呈现一例类风湿性关节炎患者在无巩膜炎情况下发生前葡萄膜炎的病例，这种情况在这类患者中非常罕见。女性患者，55岁，患有类风湿性关节炎，右眼突然出现眼痛和视力下降。她的检查显示前房反应伴前房积脓、周边角膜角膜炎和眼压32mmHg。她被诊断为高血压性前葡萄膜炎和周边角膜角膜炎，并接受了全身和局部皮质类固醇、局部抗生素、局部和全身降眼压及散瞳滴眼液治疗。前葡萄膜炎在风湿性疾病中很常见，尤其是在那些与HLA B27相关的血清阴性关节病中。在本文中，我们呈现了一名患有类风湿性关节炎且无前巩膜炎的前葡萄膜炎患者，这在实际医学文献中是一种罕见的表现。
