Dry eye disease associated with presence, severity of juvenile rheumatoid arthritis
"Dry eye is a common incident in children with [juvenile rheumatoid arthritis] and should be screened for in all patients with this disease. Severity of eye dryness is highly correlated with the disease activity," the study authors said.
The prospective analysis included 40 patients with juvenile rheumatoid arthritis and a control group comprising 20 healthy age- and sex-matched children. Mean patient age was 9.4 years in the study group and 8.8 years in the comparator group.
Patients underwent medical history, clinical examination and complete ophthalmic evaluation. Tear film break-up time, Schirmer-1 testing and corneal fluorescein staining were also assessed.
Study results showed that 30 patients had findings consistent with a diagnosis of dry eye. Twenty patients showed first-degree dryness, eight patients showed second-degree dryness, and two patients showed third-degree dryness.
Children with juvenile rheumatoid arthritis had mean tear film break-up time of 5.85 seconds and Schirmer-1 test score of 5.31 mm. Controls had mean tear film break-up time of 13.85 seconds and Schirmer-1 score of 13 mm. The between-group differences were statistically significant (P < .0001).
The mean fluorescein staining score was 1.48 in children with juvenile rheumatoid arthritis and 0.298 in controls; the difference was statistically significant (P = .0005).
Total dry eye scores were appreciably lower during juvenile rheumatoid arthritis remission than during active disease.
Tear film break-up time and Schirmer-1 test scores diminished with longer duration of juvenile rheumatoid arthritis, the authors said.