Assessment of Corneal and Tear Film Parameters in Rheumatoid Arthritis Patients Using Anterior Segment Spectral Domain Optical Coherence Tomography

ABSTRACT

Purpose: To study the corneal changes in rheumatoid arthritis (RA) patients in vivo, using spectral domain anterior segment optical coherence tomography (AS-OCT).

Methods: A case–control study was done on 43 RA patients and 40 controls. The disease activity score (DAS28-ESR) was calculated and all participants had lower tear meniscus, corneal thickness, and epithelial thickness evaluation using AS-OCT.

Results: The lower tear meniscus height (LTMH) and the lower tear meniscus area (LTMA) were significantly lower in the RA patients than in controls (p < 0.001). RA patients also had a significantly thinner central corneal thickness (p = 0.02) and their epithelium was found to be thinner in the superotemporal peripheral sector.

Conclusions: The LTMH and LTMA are significantly reduced in RA patients, despite the absence of clinical diagnosis of dry eye. RA patients have thinner corneal thickness and epithelial thickness than controls, which did not correlate with either disease duration or activity.

Keywords:

• AS-OCT
• corneal epithelium thickness
• dry eye
• lower tear meniscus
• rheumatoid arthritis

ACKNOWLEDGMENTS

The authors would like to thank Dr Youssef Farag, MD and MPH, of Harvard Medical School, for the critical review of this article, and his helpful advice.

SUPPLEMENTAL DATA

Supplemental data for this article can be accessed on the publisher’s website.

DECLARATION OF INTEREST

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.