Department of Dermatology, Medical University of Bialystok, Białystok, Poland.
Department of Ophthalmology, Independent Public University Eye Hospital, Medical University of Warsaw, Warsaw, Poland.
J Eur Acad Dermatol Venereol. 2024 Aug;38(8):1522-1530. doi: 10.1111/jdv.19773. Epub 2023 Dec 22.
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.
To investigate the frequency of DES symptoms in psoriatic patients, also regarding psoriasis severity in PASI, manifestation and therapy.
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.
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.
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.
银屑病是与多种合并症相关的最常见皮肤病之一。已有一些关于其与眼部疾病可能相关的报道,但此类患者的干眼症(DES)尚未得到充分研究。
调查银屑病患者中 DES 症状的频率,同时还研究 PASI 中银屑病的严重程度、表现和治疗与 DES 的关系。
本研究纳入了 40 例银屑病患者和 40 名无皮肤病的志愿者。他们填写了眼表疾病指数(OSDI)问卷,并使用 IDRA®设备进行了客观检查,以进行自动干涉测量、下眼睑睑板腺自动照相、非侵入性泪膜破裂时间(NIBUT)、眨眼质量和泪膜高度测量。
与对照组相比,银屑病患者的左眼和右眼的脂质层明显更厚(p=0.0042 和 p=0.0313),并且睑板腺丢失更多(p=0.0128 和 p=0.048)。与对照组相比,患者的眨眼质量和泪膜高度虽然较低但无统计学意义,NIBUT 较短,OSDI 评分较高。将患者分为有指甲受累/银屑病关节炎/全身治疗和无指甲受累/银屑病关节炎/全身治疗两组后,两组之间未观察到任何显著差异。PASI 与任何 DES 参数均无相关性。
这是首次使用客观的 IDRA®分析仪研究 DES 症状。我们发现,银屑病患者的脂质层较厚,下眼睑的睑板腺丢失更多。基于所有评估的客观和主观参数,银屑病患者似乎没有增加发生 DES 的风险。银屑病关节炎或指甲受累的存在似乎不是 DES 发生的一个诱发因素。PASI 可能不能作为任何与 DES 相关参数的预后因素。然而,银屑病中的 DES 需要在更大的样本中进行进一步研究,以制定可靠的建议。