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Li SH, Cheng CY. Risks of glaucoma among individuals with psoriasis: a population-based cohort study. Clin Exp Dermatol 2024; 49:1007-1015. [PMID: 38469696 DOI: 10.1093/ced/llae073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 01/04/2024] [Accepted: 02/29/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Psoriasis is a chronic systemic disorder with ocular involvement. OBJECTIVES To evaluate the risk of glaucoma among patients with psoriasis. METHODS Participants in this cohort study were selected based on Chang Gung Research Database from 1 January 2003 to 31 December 2012. Follow-up ended on 31 December 2017. The participants in the control group were matched with the psoriasis group by sex, age and index date with a 4 : 1 ratio. The hazard ratios of glaucoma were estimated using Cox regression analysis. We also evaluated the relationship between the risk of glaucoma and systemic therapies as well as phototherapy and topical corticosteroid in patients with psoriasis. RESULTS In total, 6682 patients with psoriasis and 26 728 matched controls were enrolled. The study population was composed mainly of males accounting for 64.2% (21 445/33 410) of the study population. The psoriasis group had higher incidence rates than the control group for glaucoma (adjusted hazard ratio 1.405, 95% confidence interval, 1.051-1.879). Patients with psoriasis receiving psoralen-ultraviolet A (PUVA) therapy for > 200 sessions had an increased risk of glaucoma. CONCLUSIONS Patients with psoriasis had an increased risk of glaucoma. Long-term PUVA therapy raised the risk of glaucoma in people with psoriasis.
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Affiliation(s)
- Shu-Hao Li
- Department of Dermatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chun-Yu Cheng
- Department of Dermatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Center of Tissue Engineering, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Nowowiejska J, Ordon AJ, Baran A, Izdebska J, Woźniak B, Kaminski TW, Szaflik J, Flisiak I. Dry eye syndrome symptoms in patients with psoriasis. J Eur Acad Dermatol Venereol 2024; 38:1522-1530. [PMID: 38140772 DOI: 10.1111/jdv.19773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 11/22/2023] [Indexed: 12/24/2023]
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.
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Affiliation(s)
- Julia Nowowiejska
- Department of Dermatology, Medical University of Bialystok, Białystok, Poland
| | - Agata Joanna Ordon
- Department of Ophthalmology, Independent Public University Eye Hospital, Medical University of Warsaw, Warsaw, Poland
- Department of Binocular Vision Pathophysiology and Strabismus, Medical University of Lodz, Lodz, Poland
| | - Anna Baran
- Department of Dermatology, Medical University of Bialystok, Białystok, Poland
| | - Justyna Izdebska
- Department of Ophthalmology, Independent Public University Eye Hospital, Medical University of Warsaw, Warsaw, Poland
| | - Bartosz Woźniak
- Department of Ophthalmology, Independent Public University Eye Hospital, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz W Kaminski
- Pittsburgh Heart, Lung and Blood Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jacek Szaflik
- Department of Ophthalmology, Independent Public University Eye Hospital, Medical University of Warsaw, Warsaw, Poland
| | - Iwona Flisiak
- Department of Dermatology, Medical University of Bialystok, Białystok, Poland
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Oliveira RDC, Faneli AC, Amaral DC, Chagas JM, Guedes J, Follador I, de Oliveira MDFSP, Fernandes BF, Correia LCL. Ocular complications in adults with psoriasis: a cross-sectional study in a referral center in Brazil. Int Ophthalmol 2024; 44:215. [PMID: 38705919 PMCID: PMC11070383 DOI: 10.1007/s10792-024-03147-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 04/11/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE There is limited literature on the ocular manifestations in patients with psoriasis. Therefore, this study aimed to identify the prevalence of and factors associated with ocular manifestations in adults with psoriasis. METHODS This cross-sectional study included Brazilian adults with psoriasis. The dermatological evaluation included diagnosis, clinical form, Psoriasis Area and Severity Index (PASI) measurement, and location of the lesions. Patients underwent a full ophthalmological examination, including the Schirmer I test, Rose Bengala staining, and tear breakup time tests. The results were analyzed using chi-square and Pearson's linear correlation tests. RESULTS Of the 130 patients assessed, 118 (90.8%) exhibited ocular abnormalities, with meibomian gland dysfunction (MGD) being the most prevalent (59.2%), followed by dry eye disease (DED) (56.2%). A significant correlation was observed between MGD and PASI (p = 0.05), and between MGD and certain treatment modalities. DED was significantly associated with PASI (p < 0.05). Concurrent use of acitretin was identified as an independent predictor of MGD (odds ratio [OR] = 3.5, p < 0.05), whereas PASI was a protective factor against DED (OR = 0.39, p < 0.01). CONCLUSION Given the high prevalence of eye disease among individuals with psoriasis, routine ophthalmological assessments are recommended to prevent possible ocular complications.
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Affiliation(s)
| | - Adriano Cypriano Faneli
- Bahiana School of Medicine and Public Health, Rua Machado Neto, 129, Pituba, Salvador, Bahia, CEP 41830-510, Brazil.
| | - Dillan Cunha Amaral
- Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Jaime Guedes
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA
| | - Ivonise Follador
- University Hospital Complex Professor Edgard Santos (HUPES) - Federal University of Bahia, Salvador, Brazil
| | | | | | - Luis Claudio Lemos Correia
- Bahiana School of Medicine and Public Health, Rua Machado Neto, 129, Pituba, Salvador, Bahia, CEP 41830-510, Brazil
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Patt YS, Ben-Shabat N, Sharif K, David P, Patt C, Elizur Y, Shani U, Zacay G, Watad A, Amital H. Unraveling the connection: Uveitis prevalence and risk factors in psoriasis patients - a population-based study. J Dermatol 2024; 51:558-566. [PMID: 38293738 DOI: 10.1111/1346-8138.17123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/08/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024]
Abstract
The association between uveitis and spondyloarthropathy (SpA)-related conditions is well-established. However, evidence describing the link between uveitis and psoriasis, and psoriasis without concomitant SpA-related conditions is scarce and conflicting. This large-scale population-based study sought to describe the prevalence and features of uveitis among psoriasis patients in Israel as well as investigating the risk for uveitis in different subgroups of psoriasis patients compared to the general population. We conducted a retrospective study utilizing the electronic database of the Meuhedet Health Maintenance Organization. The study included all patients diagnosed with psoriasis between 2000 and 2020, each patient was matched with four controls based on age, sex, place of residence, and index date. Logistic regression models were employed to assess the association between psoriasis and uveitis while adjusting for the presence of SpA-related conditions. A total of 61 003 psoriasis patients and 244 012 matched controls were included. The prevalence of uveitis was 1.3% versus 1.1% respectively (OR 1.12; 95% CI 1.10-1.30; p < 0.001). When adjusting to psoriasis severity, concurrent SpA, and psoriasis treatment no significant association was found. The rates of uveitis among psoriasis patients with concurrent SpA-related conditions was 3.2% compared to 1.4% in controls without psoriasis or SpA (OR 2.38; 95% CI 2.00-2.83; p < 0.001), while in psoriasis patients without SpA, the rate of uveitis was 1.0% and was similar to controls. Although crude rates of uveitis were higher in patients with severe psoriasis compared to mild psoriasis (2.1% vs. 1.1%), after adjustment, no significant association compared to controls was found in either group. Our findings suggest that the positive association between psoriasis and uveitis is primarily mediated by the coexistence of other SpA-related conditions. These findings imply the presence of a shared pathogenetic mechanism and set the direction for a phenotypic-targeted screening strategy.
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Affiliation(s)
- Yonatan Shneor Patt
- Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Niv Ben-Shabat
- Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Kassem Sharif
- Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Department of Gastroenterology, Sheba Medical Center, Tel-Hashomer, Israel
| | - Paula David
- Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Chen Patt
- Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
- The Adelson School of Medicine, Ariel University, Ariel, Israel
| | - Yoav Elizur
- Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Uria Shani
- Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Galia Zacay
- Department of Family Medicine, Meuhedet Health Maintenance Organization, Tel Aviv, Israel
- Department of Family Medicine, Sackler Faculty of Medicine, University of Tel Aviv, Tel Aviv, Israel
| | - Abdulla Watad
- Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Molecular Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK
| | - Howard Amital
- Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Esen Baris M, Kuscu Akdeniz F, Unal I, Guven Yilmaz S. Alterations in Retinal Vascularity in Severe Psoriasis. Ocul Immunol Inflamm 2024; 32:276-280. [PMID: 36731518 DOI: 10.1080/09273948.2023.2166536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 02/04/2023]
Abstract
PURPOSE To evaluate the changes in retinal vascularity in patients with severe psoriasis. MATERIALS AND METHODS Patients with severe psoriasis [psoriasis area-severity index (PASI) >10] who did not get any systemic treatment in the last year and do not have any ocular diseases were included. All patients underwent detailed ophthalmological examination, including optical coherence tomography (OCT) and OCT angiography (OCTA). Vessel densities (VD) of Superficial (SCP) and deep (DCP) capillary plexus, foveal avascular zone (FAZ) diameter, central retinal thickness (CRT) were analyzed and compared with age-sex matched healthy adults. RESULTS Fifty-three patients (13 F, 40 M) and 56 controls (16 F, 40 M) were included in the study. VD of SCP (50.4%±3.9 vs. 51.4%±3.2) and DCP (52.6%±6.4 vs. 55.4%±5.7) were lower in psoriasis group compared to controls (p < .05). Presence of psoriatic arthritis was related with an increased CRT (p = .000), larger FAZ and decreased foveal VD in SCP (p = .01, p = .02, respectively). CONCLUSION Severe psoriasis causes a decrease in retinal blood flow and presence of psoriatic arthritis is related with decreased foveal VD.
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Affiliation(s)
- Mine Esen Baris
- Department of Ophthalmology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Funda Kuscu Akdeniz
- Department of Dermatology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Idil Unal
- Department of Dermatology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Suzan Guven Yilmaz
- Department of Ophthalmology, Ege University Faculty of Medicine, Izmir, Turkey
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Yusufoglu E, Gurok N. Evaluation of the retinal nerve fiber layer and choroidal thickness with optical coherence tomography in patients with psoriasis. Photodiagnosis Photodyn Ther 2023; 44:103873. [PMID: 37918560 DOI: 10.1016/j.pdpdt.2023.103873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND To evaluate the retinal nerve fiber layer (RNFL), central retinal thickness (CRT), and choroidal thickness (CT) in patients with psoriasis. METHODS The study included 43 patients diagnosed with psoriasis not receiving systemic treatment and 41 healthy volunteers. Spectral domain optical coherence tomography was used for retinal and choroidal thickness measurements. The mean RNFL, quadrant RNFL (superior, inferior, nasal, temporal), and CRT values were recorded. The choroidal thickness measurements were taken from the subfoveal area, towards the temporal and nasal directions from the fovea at distances of 500, 1000, and 1500 µm. RESULTS The RNFL was determined to be thinner in the superior quadrant (p=0.025), and the CT was thicker at all the measurement points (p < 0.05) in the patients with psoriasis. The CRT values were similar in both groups (p > 0.05). No correlation was determined between the parameters measured and disease duration or severity. CONCLUSIONS Thinning of the RNFL and increased CT may be a sign of choroidal microvascular changes and ganglion cell damage due to psoriasis.
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Affiliation(s)
- Elif Yusufoglu
- Elazig Fethi Sekin City Hospital, Eye Clinic, Elazig, Turkey.
| | - Nese Gurok
- Elazig Fethi Sekin City Hospital, Dermatology Clinic, Elazig, Turkey.
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Sedghi T, Torre K, Suchecki J, Rothe M. The ocular and periocular involvement of psoriasis. Clin Dermatol 2023; 41:515-522. [PMID: 37619649 DOI: 10.1016/j.clindermatol.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Ocular manifestations of psoriasis are generally underrepresented in the literature and can often be missed by clinicians. Appreciation of eye involvement in psoriasis is especially important for dermatologists and ophthalmologists who may be closely involved with treating afflicted patients. Depending on the involved site and severity of the condition, signs and symptoms of ocular psoriasis can vary from asymptomatic erythema to debilitating scarring and vision loss. Treatment is critical to prevent disease progression and to improve the quality of life for these patients. We discuss the various clinical manifestations and treatment options for ocular complications in patients with psoriasis, including specific circumstances that should trigger immediate referral to our ophthalmology colleagues.
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Affiliation(s)
- Tannaz Sedghi
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Kristin Torre
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Jeanine Suchecki
- Department of Surgery, Division of Ophthalmology, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Marti Rothe
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, USA.
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Evaluation of corneal topographic parameters in patients with psoriasis. Photodiagnosis Photodyn Ther 2023; 41:103280. [PMID: 36627067 DOI: 10.1016/j.pdpdt.2023.103280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/23/2022] [Accepted: 01/04/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND To evaluate corneal topographic parameters in patients with psoriasis. METHODS This prospective, cross-sectional study included 50 right eyes of 50 patients with psoriasis and 50 right eyes of 50 age- and sex-matched healthy individuals. Detailed dermatological and ophthalmological examinations were performed in all cases. Noninvasive tear break-up time (NIBUT), meibography, keratometry values, and high-order corneal aberrations (HOAs) were obtained using corneal topography and compared to healthy subjects. These values were also evaluated according to anti-tumor necrosis factor alpha (anti-TNF-α) use, the Psoriasis Area and Severity Index (PASI) score, psoriasis duration, and patient age. The chi-square test, Mann-Whitney U test, and Pearson correlation test were used for statistical assessment. RESULTS Lower NIBUT and higher meibomian gland loss (MGL) were detected in psoriasis patients compared to healthy controls. There were no significant differences between the groups in terms of corneal HOAs. Higher MGL was detected in patients using anti-TNF-α than in patients not using it. A positive correlation was found among topographic parameters, especially between PASI score and the patient's age. No correlations were found between the disease duration and the other parameters. CONCLUSION NIBUT and MGL are more common in psoriasis patients than in healthy subjects. The relationship between anti-TNF-α use, PASI score, patient age, and corneal parameters should be considered in the follow-up and treatment of ocular findings in psoriasis patients.
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Aryanian Z, Shirzadian A, Hatami P, Roostayi GA, Najafi S, Goodarzi A. Ocular manifestations of psoriasis: An inflammatory disease beyond the skin. J Gen Fam Med 2023; 24:45-49. [PMID: 36605906 PMCID: PMC9808144 DOI: 10.1002/jgf2.576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/01/2022] [Accepted: 08/14/2022] [Indexed: 02/01/2023] Open
Abstract
Background Psoriasis is a chronic inflammatory disorder, mainly involves skin. Aims To evaluate the prevalence of ocular manifestations in Iranian patients with psoriasis, compared to healthy controls. Materials and methods Forty psoriasis patients and 40 age- and gender-matched healthy controls were enrolled in the study and underwent a comprehensive ophthalmologic assessment. Results Only meibomian gland dysfunction was significantly more common among patients with psoriasis, compared to control group (p value: 0.011). Regarding intraocular pressure (IOP), the mean values for both patients and healthy controls were within the normal range and mean IOP in patients was even lower than normal controls, although this difference was significant only for left eye (p value: 0.049). A strong positive correlation between PASI and tear meniscus height for both right and left eyes (p value: 0.005, r: 0.44 for OD and p value: 0.003, r: 0.46 for OS.) was noted. Meibomian gland dysfunction was also positively correlated with disease duration for right and left palpebras (p: 0.04, r: 0.31 for both). Conclusion Psoriasis can lead to meibomian gland dysfunction, especially in patients with long-lasting disease. Hence, dermatologists and general practitioners should be vigilant in this regard when visiting psoriasis patients, especially those who have higher PASI values or long-lasting disease.
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Affiliation(s)
- Zeinab Aryanian
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
- Department of DermatologyBabol University of Medical SciencesBabolIran
| | - Azar Shirzadian
- Department of DermatologyBabol University of Medical SciencesBabolIran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
| | | | - Sadrollah Najafi
- Student Research CommitteeBabol University of Medical SciencesBabolIran
| | - Azadeh Goodarzi
- Department of Dermatology, School of Medicine, Rasool Akram Medical Complex Clinical Research Development CenterIran University of Medical SciencesTehranIran
- Skin and Stem Cell Research CenterTehran University of Medical SciencesTehranIran
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Bustamante-Arias A, Ruiz Lozano RE, Rodriguez-Garcia A. Dry eye disease, a prominent manifestation of systemic autoimmune disorders. Eur J Ophthalmol 2022; 32:3142-3162. [PMID: 35300528 DOI: 10.1177/11206721221088259] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Dry eye disease (DED) is arguably the most frequent ocular disease encountered in ophthalmic clinical practice. DED is frequently an underestimated condition causing a significant impact on visual function and quality of life. Many systemic autoimmune diseases (SAIDs) are related to moderate to severe DED. The main objective of this review is to enhance the awareness among ophthalmologists of the potential association of an underlying SAID in a high-risk patient with DED. METHODS An exhaustive literature search was performed in the National Library of Medicine's Pubmed, Scopus, Web of Science, and Google Scholar databases for all English language articles published until November 2021. The main keywords included "dry eye disease" associated with autoimmune, connective tissue, endocrine, gastrointestinal, hematopoietic, vascular, and pulmonary diseases. Case reports, series, letters to the editor, reviews, and original articles were included. RESULTS Although DED is frequently associated with SAIDs, its diagnosis is commonly delayed or missed, producing significant complications, including corneal ulceration, melting, scleritis, uveitis, and optic neuritis resulting in severe complications detrimental to visual function and quality of life. SAID should be suspected in a woman, 30 to 60 years old with a family history of autoimmunity, presenting with DED symptoms and extraocular manifestations including arthralgias, dry mouth, unexplained weight and hair loss, chronic fatigue, heat or cold intolerance, insomnia, and mood disorders. CONCLUSIONS Establishing the correct diagnosis and treatment of DED associated with SAIDs is crucial to avoid its significant burden and severe ocular complications.
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Affiliation(s)
- Andres Bustamante-Arias
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences. Monterrey, Mexico
| | - Raul E Ruiz Lozano
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences. Monterrey, Mexico
| | - Alejandro Rodriguez-Garcia
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences. Monterrey, Mexico
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Identifying and Treating Ocular Manifestations in Psoriasis. Am J Clin Dermatol 2022; 23:51-60. [PMID: 34731450 DOI: 10.1007/s40257-021-00648-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2021] [Indexed: 01/04/2023]
Abstract
Psoriasis is a chronic immune-mediated inflammatory skin condition that commonly presents with red, thickened, and scaling plaques. Given the prominent cutaneous manifestations of psoriasis, more subtle ophthalmic findings of the disease may initially go undetected, with the potential for significant ocular morbidity. Associated ocular disease can involve nearly any structure of the eye, with the eyelids most commonly being affected, resulting in relatively common signs and symptoms of ocular surface discomfort. The presence of intraocular inflammation (i.e., uveitis) or retinal involvement carry a heightened risk of vision loss, and are often more difficult to diagnose outside of the ophthalmology clinic. Early detection and treatment of ocular disease can limit morbidity and are critical to the management of these patients, which requires coordination of care between dermatologists and ophthalmologists. The objective of this article was to review the most common ocular conditions that affect psoriatic patients, when to consider referral to an ophthalmologist, and to summarize the adverse ocular effects of current psoriasis treatments.
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Kemeriz F, Tugrul B, Yasar E. Evaluation of ocular psoriasis with meibography. An Bras Dermatol 2021; 97:22-27. [PMID: 34785066 PMCID: PMC8799865 DOI: 10.1016/j.abd.2021.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/24/2021] [Accepted: 05/04/2021] [Indexed: 11/23/2022] Open
Abstract
Background Previous studies has shown that dry eye test abnormalities, meibomian gland dysfunction (MGD), may occur in psoriasis. Objectives The authors aimed to evaluate the dry eye disease (DED), MGD, in psoriasis patients with meibography which is a current, objective, noninvasive method for patients with meibomian gland diseases, to investigate the relationship between disease severity and ocular involvement. Methods This study included 50 participants with psoriasis and 50 healthy individuals. All subjects were examined by the same dermatologist and referred for ophthalmological examination including meibomian gland obstruction, lid margin alterations assessment, ocular surface disease index assessment, tear film break-up time test, Schirmer test, corneal conjunctival fluorescein staining assessment. Additionally, upper and lower lids were evaluated for meibomian gland loss with meibography. Results MGD (28%), meibomian gland loss (MGL) (29.5%), upper meiboscore (0.61 ± 0.81), lower meiboscore (0.46 ± 0.61), DED (22%) were significantly higher in the psoriasis group compared with the control group (p = 0.008, p < 0.001, p = 0.027, p = 0.041, p = 0.044, respectively). There was a significant relationship between MGD and psoriasis area severity index (PASI) (p = 0.015, Odds Ratio = 1.211). There was a significant positive relationship between MGL with PASI (p < 0.001, r = 608) and psoriasis duration (p < 0.001, r = 0.547). Study limitations Smaller study group and inability to detect quality changes of meibum with meibography were limitations of the study. Conclusions Psoriasis may affect the meibomian gland morphology, may cause structural changes in meibomian glands, and as a result of these may cause MGD and DED. Therefore, ophthalmologists and dermatologists should be aware of this situation and co-evaluate the patients in this respect.
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Affiliation(s)
- Funda Kemeriz
- Department of Dermatology, Aksaray University Faculty of Medicine, Aksaray, Turkey.
| | - Burcu Tugrul
- Department of Dermatology, Health Science University Ankara City Hospital, Ankara, Turkey
| | - Erdogan Yasar
- Department of Ophthalmology, Aksaray University Faculty of Medicine, Aksaray, Turkey
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Analysis of corneal densitometry and endothelial morphometry in patients with psoriasis. Photodiagnosis Photodyn Ther 2021; 36:102522. [PMID: 34487872 DOI: 10.1016/j.pdpdt.2021.102522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/30/2021] [Accepted: 08/30/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND To evaluate corneal endothelial properties and corneal densitometry values in patients with psoriasis and to compare the results with those of healthy controls. METHODS This prospective, comparative, and cross-sectional study included 106 eyes of 53 patients who were diagnosed with psoriasis and 106 eyes of 53 age-gender matched healthy controls. All patients were evaluated in terms of ocular surface tests such as Schirmer-1 and tear break-up time (TBUT). Corneal endothelial measurements were performed using noncontact specular microscopy. Corneal tomographic and densitometric measurements were obtained using the Scheimpflug imaging system. Measurements were also evaluated according to the psoriasis area and severity index (PASI) score. RESULTS The mean TBUT and Schirmer 1 test values were significantly lower in the psoriasis group than in the healthy controls (p = 0.02, p < 0.001, respectively). While the mean endothelial cell density was significantly lower in patients with psoriasis than the healthy controls (2389.9±314.9 cells/mm2 vs. 2512.4±289.7 cells/mm2, p = 0.02), the mean average endothelial cell area, standard deviation of cell area, coefficient of variation of cell area were significantly higher in patients with psoriasis (426.6±62.7 µm2 vs. 403.2±46.1 µm2, p = 0.01; 206.4±52.3 µm2 vs. 183.2±43.8 µm2, p = 0.006; and 48.1±6.3% vs. 45.7±6.7%, p = 0.04, respectively). Most of the densitometry measurements in concentric zones were higher in patients with psoriasis than in healthy controls, but none of the differences reached statistical significance. CONCLUSIONS A regular eye examination is crucial in patients with psoriasis because corneal structural and functional changes, particularly endothelial alterations, are of utmost importance in planning intraocular surgeries in patients with psoriasis.
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Chen YY, Chen HH, Lo TC, Chou P. The risk of psoriasis in patients with uveitis: A nationwide population-based cohort study. PLoS One 2021; 16:e0255492. [PMID: 34339476 PMCID: PMC8328291 DOI: 10.1371/journal.pone.0255492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 07/16/2021] [Indexed: 01/01/2023] Open
Abstract
Objective To evaluate whether the risk of subsequent psoriasis and psoriatic arthritis development is increased in patients with uveitis. Methods In Taiwan’s national health insurance research database, we identified 195,125 patients with new-onset uveitis between 2001 and 2013. We randomly selected 390,250 individuals without uveitis who were matched 2:1 to uveitis cases based on age, sex and year of enrolment. The characteristics of the two groups were compared. Using multivariate Cox regression, hazard ratios (HRs) for psoriasis or psoriatic arthritis corresponding to uveitis were computed after adjustment for age, sex, insurance cost and comorbidities. In subgroup analyses, separate HRs for mild psoriasis, severe psoriasis and psoriatic arthritis were calculated. Results The mean age of the study cohort was 50.2 ± 17.2 years. Hypertension, diabetes, hyperlipidaemia and obesity were more prevalent in the uveitis group (all p < 0.0001). The hazard of psoriasis or psoriatic arthritis development was significantly greater in the uveitis group than in the non-uveitis group (p < 0.0001); this increased risk persisted after adjustment for confounders [adjusted HR = 1.41; 95% confidence interval (CI), 1.33–1.48]. Adjusted HRs showed an increasing trend from mild psoriasis (1.35; 95% CI, 1.28–1.44) to severe psoriasis (1.59; 95% CI, 1.30–1.94) and psoriatic arthritis (1.97; 95% CI, 1.60–2.42). Conclusions This nationwide population-based cohort study revealed that patients with uveitis have an increased risk of subsequent psoriasis or psoriatic arthritis development.
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Affiliation(s)
- Yu-Yen Chen
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Community Medicine Research Center and Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
- National Chung Hsing University, Taichung, Taiwan
| | - Hsin-Hua Chen
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Community Medicine Research Center and Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
- National Chung Hsing University, Taichung, Taiwan
- Division of Allergy, Immunology, and Rheumatology & Division of General Internal Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Biomedical Science and Rong-Hsing Research Center for Translational Medicine, Chung Hsing University, Taichung, Taiwan
- Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan
- * E-mail:
| | - Tzu-Chen Lo
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Pesus Chou
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Community Medicine Research Center and Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
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15
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Constantin MM, Ciurduc MD, Bucur S, Olteanu R, Ionescu RA, Constantin T, Furtunescu F. Psoriasis beyond the skin: Ophthalmological changes (Review). Exp Ther Med 2021; 22:981. [PMID: 34345263 DOI: 10.3892/etm.2021.10413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 06/03/2021] [Indexed: 12/31/2022] Open
Abstract
Psoriasis is a chronic, immune-mediated inflammatory disease of unknown etiology that may be associated with abnormal T-lymphocyte function. Ocular manifestations associated with psoriasis, particularly artropathic or pustular psoriasis, usually affect men, often during exacerbations of the disease. It has been reported that eye damage tends to occur later compared with cutaneous or joint manifestations, blindness being the most disabling complication. Previous studies have focused on ophthalmic manifestations and identified several etiopathogenic mechanisms. Psoriasis may be associated with eye complications such as lesions of the eyelids, conjunctiva and others, with systemic inflammation being the main contributor. In addition, the treatment used for psoriasis may cause ocular changes. The main ophthalmic manifestations associated with psoriasis are keratoconjunctivitis sicca, blepharitis, conjunctivitis and uveitis. The treatment of uveitis, perceived as one of the most serious eye conditions, is controversial and has yet to be clearly determined. Thus, the aim of the present review was to emphasize the importance of regular eye examination for patients with psoriasis, either those receiving biological treatment or those not receiving treatment, in order to diagnose and manage the disease appropriately.
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Affiliation(s)
- Maria-Magdalena Constantin
- Third Department, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Second Department of Dermatology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Maria-Diana Ciurduc
- Second Department of Dermatology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Stefana Bucur
- Third Department, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Second Department of Dermatology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Rodica Olteanu
- Second Department of Dermatology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Razvan Adrian Ionescu
- Third Department, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Third Department of Internal Medicine and Rheumatology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Traian Constantin
- Third Department, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Urology, 'Prof. Dr. Th. Burghele' Hospital, 050659 Bucharest, Romania
| | - Florentina Furtunescu
- Third Department, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Public Health and Management, National Institute of Public Health, 050463 Bucharest, Romania
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16
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Goh Y, Kwan Z, Han WH, Iqbal T, Yahya F, Khang TF, Singh S. Ocular surface disease in psoriatic patients in a developing country. Int Ophthalmol 2021; 41:2139-2147. [PMID: 33788072 DOI: 10.1007/s10792-021-01771-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 03/05/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To evaluate ocular surface changes among patients with psoriasis in Malaysia, a developing country in Southeast Asia. METHODS An interdisciplinary case-control study (60 psoriasis patients and 40 control subjects) to look at the differences in ocular surface manifestations between patients with psoriasis and a group of age-, gender- and ethnicity-matched healthy controls. RESULTS One hundred and twenty eyes of 60 patients with psoriasis and 80 eyes of 40 healthy controls without psoriasis were included in the study. Mild-to-moderate psoriasis was found in 42 patients (70%), while 18 patients (30%) had severe psoriasis. Psoriatic arthritis was found in 19 patients (32%). Of the 60 psoriatic patients, the prevalence of ocular involvement was 65% (39/60), in which 32% (19/60) had dry eyes, 27% (16/60) had lid margin abnormalities, 33% (20/60) had cataract, and one had history of anterior uveitis. Compared to controls, ocular surface of psoriatic patients showed more eyelid margin abnormalities, higher meibomian gland loss and lower tear film break-up time. The estimated odds ratio for dry eyes in the psoriasis group was 2.2 (95% CI: 0.8-6.9). CONCLUSION Ocular surface disorders encompassing eyelid margin abnormalities, meibomian gland loss and tear dysfunction occur at an earlier and higher rate among psoriatic patients.
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Affiliation(s)
- Yihui Goh
- Department of Ophthalmology, Faculty of Medicine, University of Malaya Eye Research Centre, University of Malaya, Lembah Pantai, 59100, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Zhenli Kwan
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Winn Hui Han
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Tajunisah Iqbal
- Department of Ophthalmology, Faculty of Medicine, University of Malaya Eye Research Centre, University of Malaya, Lembah Pantai, 59100, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Fariz Yahya
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Tsung Fei Khang
- Department of Ophthalmology, Faculty of Medicine, University of Malaya Eye Research Centre, University of Malaya, Lembah Pantai, 59100, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia.,Institute of Mathematical Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Sujaya Singh
- Department of Ophthalmology, Faculty of Medicine, University of Malaya Eye Research Centre, University of Malaya, Lembah Pantai, 59100, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia.
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17
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Ruggiero A, Fabbrocini G, Cacciapuoti S, Cinelli E, Gallo L, Megna M. Ocular Manifestations in Psoriasis Screening (OcMaPS) Questionnaire: A Useful Tool to Reveal Misdiagnosed Ocular Involvement in Psoriasis. J Clin Med 2021; 10:1031. [PMID: 33802255 PMCID: PMC7958956 DOI: 10.3390/jcm10051031] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/18/2021] [Accepted: 02/25/2021] [Indexed: 02/07/2023] Open
Abstract
Psoriasis is an immune-mediated, chronic inflammatory disease, which mainly affects the skin, although it has systemic pathological effects. Comorbidities of psoriasis include ocular disorders, which are often nonspecific or mildly symptomatic. The aim of this study was to show the importance of ocular-disease screening in psoriatic patients using the Ocular Manifestations in Psoriasis Screening (OcMaPS) questionnaire. Patients suffering from moderate-to-severe psoriasis referring at our outpatient-clinic were consecutively enrolled. Each patient was asked to complete a screening questionnaire (OcMaPS). Patients reporting ocular symptoms were referred for an ophthalmological examination. A total of 372 patients were enrolled in the study. Ocular symptoms were detected in 39 patients (10.5%), and 37 patients were referred to ophthalmological examination which confirmed the presence of ocular manifestation in 30 patients. There were three cases (10%) of uveitis, 14 (46.6%) of dry eye and 13 (43.3%) of cataract, in progress or already treated with surgery. In the remaining seven patients, no ocular manifestations were found. Ocular manifestations in psoriatic patients are not rare. It is important to be aware of ocular symptoms in psoriatic patients, screening patients (with a consultation or OcMaPS questionnaire), which leads to earlier diagnosis and treatment.
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Affiliation(s)
| | | | | | | | | | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy; (A.R.); (G.F.); (S.C.); (E.C.); (L.G.)
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18
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Psoriasis and Risk of Uveitis: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2020; 2020:9308341. [PMID: 32724820 PMCID: PMC7381949 DOI: 10.1155/2020/9308341] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/28/2020] [Accepted: 06/27/2020] [Indexed: 12/14/2022]
Abstract
Background Uveitis is a known ophthalmologic manifestation of seronegative spondyloarthropathy, including psoriatic arthritis. However, the data is less clear among patients with psoriasis due to the limited number of published studies. Aims To investigate whether the risk of incident and prevalent uveitis is elevated among patients with psoriasis using systematic review and meta-analysis technique. Methods The MEDLINE and EMBASE databases were searched from their inception to May 2019. Eligible studies must have included a psoriasis group and a nonpsoriasis group. Eligible studies must also have investigated for prevalent or incident uveitis, and the magnitude of difference between the study groups must have been reported. Pooled risk ratio and 95% confidence interval (CI) were calculated using random-effect generic inverse variance methods. Results Of 7,107 potentially eligible articles from the EMBASE and MEDLINE databases, 7 studies were included in the meta-analysis. Two of those studies compared the incidence, and 5 studies compared the prevalence of uveitis between the psoriasis and nonpsoriasis groups. For incident uveitis, a total of 5,865,801 patients (222,083 with psoriasis and 5,643,718 without psoriasis) were analyzed. For prevalent uveitis, a total of 1,343,436 patients (37,891 with psoriasis and 1,305,545 without psoriasis) were studied. The risk of incident uveitis was significantly higher among patients with psoriasis with a pooled risk ratio of 1.23 (95% CI: 1.05-1.45, I 2 = 55%). The risk of prevalent uveitis was also significantly higher among patients with psoriasis with a pooled risk ratio of 1.97 (95% CI: 1.68-2.31, I 2 = 0%). Conclusions The results of this study revealed significantly increased risk of both prevalent and incident uveitis among patients with psoriasis.
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19
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Schargus M, Langhorst CA, Joachim S, Frings A, Krause K, Reifenberger J, Geerling G, Frings VG. Hidradenitis Suppurativa is Associated with Symptoms of Keratoconjunctivitis Sicca. Curr Eye Res 2020; 46:23-30. [PMID: 32506959 DOI: 10.1080/02713683.2020.1775259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIM OF THE STUDY Hidradenitis suppurativa (HS) and psoriasis vulgaris (PSO) are chronic inflammatory dermatoses in which proinflammatory cytokines, such as IL-17, play a central role. The prevalence of keratoconjunctivitis sicca (KCS) is commonly higher in PSO than in healthy individuals. This study was thus set up to investigate the prevalence of KCS among patients with HS. MATERIALS AND METHODS In a cross-sectional study standardized tear film parameters and symptom-oriented questionnaires (OSDI, SPEED) were analyzed in a total of 71 subjects (HS n = 20, PSO n = 20, healthy controls n = 31). Additionally, IL-17 and MMP-9 in the tear film were analyzed. These parameters were correlated to the clinical severity of the skin disease. PSO patients served as inflammatory control group. RESULTS There were statistically significant differences in OSDI (p = .003) and SPEED (p ≤ 0.001) between HS and the control group, but not between PSO and controls. For HS, there was a statistically significant correlation between symptoms (OSDI) and the severity of HS according to Hurley stage (p = .023). Tear film concentrations showed significantly increased levels of IL-17 (p = .018), but not MMP-9, in PSO alone compared to the control group. CONCLUSION Data show that subjective complaints of KCS may be associated with HS and correlate with the severity of the respective Hurley stage, but do not involve alterations of tear film MMP-9 and IL-17. Clinicians should remain mindful that ocular complications in HS are often more vague than in psoriatic patients, but dry eye symptoms might be detrimental for the patients' quality of life.
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Affiliation(s)
- Marc Schargus
- Department of Ophthalmology, Heinrich-Heine-University Düsseldorf , Düsseldorf, Germany.,Department of Ophthalmology, Asklepios Hospital Nord-Heidberg , Hamburg, Germany
| | | | - Stephanie Joachim
- Department of Ophthalmology, Experimental Eye Research Institute, Ruhr-University Bochum , Bochum, Germany
| | - Andreas Frings
- Department of Ophthalmology, Heinrich-Heine-University Düsseldorf , Düsseldorf, Germany.,UCL Institute of Ophthalmology , London, UK
| | - Kristina Krause
- Department of Dermatology, Heinrich-Heine-University Düsseldorf , Düsseldorf, Germany
| | - Julia Reifenberger
- Department of Dermatology, Heinrich-Heine-University Düsseldorf , Düsseldorf, Germany
| | - Gerd Geerling
- Department of Ophthalmology, Heinrich-Heine-University Düsseldorf , Düsseldorf, Germany
| | - Verena Gerlinde Frings
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg , Würzburg, Germany
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20
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Khalili MR, Sadati MS, Jahanbani-Ardakani H. Ocular findings in patients with psoriasis: is it related to the side effects of treatment or to psoriasis itself? A case-control study. J DERMATOL TREAT 2020; 33:595. [PMID: 32460568 DOI: 10.1080/09546634.2020.1770163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Mohammad Reza Khalili
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Sada Sadati
- Department of Dermatology, Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamidreza Jahanbani-Ardakani
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran
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21
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Li CR, Chen L, Wang LF, Yan B, Liang YL, Luo J. Association between uveitis and psoriatic disease: a systematic review and Meta-analysis based on the evidence from cohort studies. Int J Ophthalmol 2020; 13:650-659. [DOI: 10.18240/ijo.2020.04.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 03/10/2020] [Indexed: 01/22/2023] Open
Affiliation(s)
| | - Lang Chen
- General Surgery Department, the Third Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
| | - Long-Fei Wang
- Cardiovascular Department, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
| | - Bin Yan
- Department of Ophthalmology, the Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
| | - You-Ling Liang
- Department of Ophthalmology, the Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
| | - Jing Luo
- Department of Ophthalmology, the Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
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22
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Chimenti MS, Triggianese P, Salandri G, Conigliaro P, Canofari C, Caso F, Costa L, Nucci C, Aiello F, Cesareo M, Perricone R. A Multimodal Eye Assessment in Psoriatic Arthritis Patients sine-Psoriasis: Evidence for a Potential Association with Systemic Inflammation. J Clin Med 2020; 9:jcm9030719. [PMID: 32155870 PMCID: PMC7141327 DOI: 10.3390/jcm9030719] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 02/29/2020] [Accepted: 03/02/2020] [Indexed: 12/26/2022] Open
Abstract
Background: Ocular involvement in Psoriatic Arthritis (PsA) patients is mainly associated with uveitis but there remains a paucity of data on dry eye and retinal abnormalities. We aimed to analyze dry eye and subclinical retinal abnormalities in a cohort of PsA patients sine-psoriasis (PsO). Methods: PsA patients sine-PsO were enrolled. Best-corrected-visual-acuity, ocular-surface-disease-index (OSDI), Schirmer test, tear film breakup-time, standard-automated-perimetry (SAP, mean deviation—MD, pattern standard deviation—PSD), fundus-perimetry (FP), and spectral-domain-optical-coherence-tomography (SD-OCT) were performed. Results: A total of 80 eyes from 40 PsA patients with moderate-severe disease activity, and 70 eyes from 35 healthy control (HC) were evaluated. Higher dry eye prevalence occurred in PsA than HC (p < 0.0001). ESR was positively related with OSDI (p < 0.001) and negatively related with Schirmer (p = 0.007). In PsA, SAP registered higher MD (p < 0.0001) and higher PSD (p = 0.005) in comparison with HC. PSD resulted positively correlated with ESR (p = 0.04) and CRP (p = 0.01), while MD showed a negative correlation with CRP (p = 0.01). Both FP mean differential sensitivity and mean defect were lower in PsA then HC (p < 0.0001). In PsA, FP differential sensitivity was directly related with cumulative steroids (p = 0.02). Conclusions: In PsA patients sine-PsO, dry eye and subclinical abnormalities in visual functions occurred being potentially related to systemic inflammation.
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Affiliation(s)
- Maria Sole Chimenti
- Rheumatology, Allergology and Clinical Immunology, Department of “Medicina dei Sistemi”, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Paola Triggianese
- Rheumatology, Allergology and Clinical Immunology, Department of “Medicina dei Sistemi”, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giorgia Salandri
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Paola Conigliaro
- Rheumatology, Allergology and Clinical Immunology, Department of “Medicina dei Sistemi”, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Claudia Canofari
- Rheumatology, Allergology and Clinical Immunology, Department of “Medicina dei Sistemi”, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Francesco Caso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
| | - Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Francesco Aiello
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- Correspondence: ; Tel.: +39-333-258-1755
| | - Massimo Cesareo
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Roberto Perricone
- Rheumatology, Allergology and Clinical Immunology, Department of “Medicina dei Sistemi”, University of Rome Tor Vergata, 00133 Rome, Italy
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