Inderjit Kaur

To Study The Prevalence of Ocular Manifestations in Rheumatoid Arthritis And their Correlation with Anti Cyclic Citrullinated Peptide Antibodies And Rheumatoid Factor .

Introduction: Ocular involvement in rheumatoid arthritis (RA) is significant as sometimes if missed can be potentially blinding.Their presence also aids in making the final diagnosis of RA with atypical presentation. During the course of treatment of RA ,flaring of ocular signs and symptoms may signal impending deterioration or relapse of RA . Thus the study was undertaken in our tertiary care hospital to know the prevalence of ocular manifestations in patients of RA and their correlation with disease activity. Material and Methods: The present prospective observational study was conducted in Regional Institute of ophthalmology on 139 patients of rheumatoid arthritis. Detailed ocular examination was done and besides routine investigations RA factor(RF) and anti cyclic citrullinated peptide antibodies(ACCP) of each patient was recorded.Chi-square test was used to correlate their significance to ocular manifestations. Probability (p) value less than 0.05 was considered significant. Results: Among 139 patients of rheumatoid arthritis included in our study , 53(38%) patients had ocular signs and symptoms. 31(22 %) patients had dry eye,13(9%) had keratoconjunctivitis sicca(KCS), 7 (5%) had anterior uveitis , 4(3%) had episcleritis, 3(2%) had scleritis, 2(1.4%) had peripheral ulcerative keratitis(PUK), 2(1.4%) had sclerosing keratitis, 5(3.5%) had cataract,and1(0.7%) had rental vasculitis. The prevalence of ocular manifestations was significantly higher in patients with positive serology than those with negative serology (p .05) Conclusion: Patients of rheumatoid arthritis need to get routine ocular examination for the early diagnosis and timely management so as to prevent permanent irreparable loss of vision. The presence of anti CCP antibodies and RF provides effective clue to ophthalmologists for identifying patients at risk for vision threatening inflammatory ocular complications.