Liu Yingyi, Wu Mengbo, Ren Yuerong, Feng Jianing, Shi Wen, Kang Huanmin, Tian Jing, He Yan
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmic and Visual Science Key Laboratory, Beijing, China.
Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
Ocul Immunol Inflamm. 2024 Nov;32(9):2018-2030. doi: 10.1080/09273948.2024.2315196. Epub 2024 Feb 16.
To evaluate dry eye severity and ocular surface inflammation in autoimmune rheumatic diseases (ARDs).
Seventy-nine patients with ARDs were enrolled, including 26 patients with rheumatoid arthritis (RA), 33 patients with systemic lupus erythematosus (SLE), and 20 patients with primary Sjögren's syndrome (pSS). All patients underwent ocular surface evaluations, including ocular surface symptoms, signs, conjunctival impression cytology, and tear multicytokine detection. Systemic conditions, including disease duration, disease activity, and serological parameters, were also noted.
SLE patients had the shortest disease duration, and nearly half of them had low disease activity, while RA patients and pSS patients had a relatively long disease duration, and approximately 90% of them had moderate or high disease activity. The incidence of dry eye and the levels of the proinflammatory tear cytokines in SLE were significantly lower than those in RA and pSS. However, ocular surface squamous metaplasia was more severe in SLE and pSS than in RA. Dry eye severity in all ARD patients was shown to be independent of disease activity, while Nelson's grades were positively correlated with disease duration in RA patients. Disease-related serological parameters were associated with tear proinflammatory cytokines in all ARD patients.
Variable degrees of dry eye and immune-mediated ocular surface inflammation persist in different ARD patients. In addition to a well-known association between dry eye and pSS, dry eye is also commonly observed in SLE and RA patients. Therefore, there is a definite need for regular ophthalmologic evaluations and topical medications in all patients with ARDs.
评估自身免疫性风湿性疾病（ARDs）患者的干眼严重程度和眼表炎症。
纳入79例ARDs患者，其中类风湿关节炎（RA）患者26例、系统性红斑狼疮（SLE）患者33例、原发性干燥综合征（pSS）患者20例。所有患者均接受眼表评估，包括眼表症状、体征、结膜印迹细胞学检查及泪液多种细胞因子检测。同时记录患者的全身情况，包括病程、疾病活动度及血清学参数。
SLE患者病程最短，近半数患者疾病活动度低，而RA患者和pSS患者病程相对较长，约90%患者疾病活动度为中度或高度。SLE患者干眼发病率及促炎泪液细胞因子水平显著低于RA患者和pSS患者。然而，SLE和pSS患者的眼表鳞状化生比RA患者更严重。所有ARDs患者的干眼严重程度与疾病活动度无关，而RA患者的尼尔森分级与病程呈正相关。所有ARDs患者与疾病相关的血清学参数与泪液促炎细胞因子有关。
不同ARDs患者存在不同程度的干眼和免疫介导的眼表炎症。除了干眼与pSS之间的众所周知的关联外，干眼在SLE和RA患者中也很常见。因此，所有ARDs患者确实需要定期进行眼科评估和局部用药。
