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Conjunctival Impression Cytology and Tear-Film Changes in Patients With Inflammatory Bowel Disease. Eye Contact Lens 2018; 44 Suppl 2:S420-S425. [DOI: 10.1097/icl.0000000000000537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Gökmen O, Yeşilırmak N, Akman A, Gür Güngör S, Yücel AE, Yeşil H, Yıldız F, Sise A, Diakonis V. Corneal, Scleral, Choroidal, and Foveal Thickness in Patients with Rheumatoid Arthritis. Turk J Ophthalmol 2017; 47:315-319. [PMID: 29326847 PMCID: PMC5758765 DOI: 10.4274/tjo.58712] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 05/09/2017] [Indexed: 12/03/2022] Open
Abstract
Objectives: To investigate corneal, scleral, choroidal, and foveal thicknesses in female patients with rheumatoid arthritis (RA) and compare them with healthy subjects. Materials and Methods: This prospective study included consecutive female patients diagnosed with RA and healthy subjects. Corneal, scleral, choroidal, and retinal (foveal) thicknesses were obtained by using optical coherence tomography and a comparison was performed between groups for all outcome measures. Results: Thirty-six eyes of 36 female patients diagnosed with RA (group 1) and 36 eyes of 36 healthy female volunteers (group 2) were included. Mean corneal, scleral, choroidal thicknesses and retinal thickness at the fovea of group 1 were 543.3±33.7 µm, 343.7±42.2 µm, 214.6±50, and 213.5±18.9 µm, respectively; in group 2, these values were 549.9±29.6 μm, 420.9±42.4 μm, 206.4±41.9 μm, and 222±15.5 μm, respectively. The comparison between group 1 and 2 with respect to corneal, choroidal, and foveal thicknesses did not reveal statistical significant differences (p>0.05). On the contrary, there was a statistically significant difference with respect to scleral thickness between the groups, with the RA patients demonstrating a thinner scleral layer (p<0.001). Conclusion: Female patients with RA seem to demonstrate statistically significant scleral thinning when compared with healthy subjects, while there was no difference concerning corneal, choroidal, and foveal thickness.
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Affiliation(s)
- Onur Gökmen
- University of Health Sciences, Van Training and Research Hospital, Department of Ophthalmology, Van, Turkey
| | - Nilüfer Yeşilırmak
- University of Health Sciences, Ankara Training and Research Hospital, Department of Ophthalmology, Ankara, Turkey
| | - Ahmet Akman
- Başkent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
| | - Sirel Gür Güngör
- Başkent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
| | - Ahmet Eftal Yücel
- Başkent University Faculty of Medicine, Department of Rheumatology, Ankara, Turkey
| | - Hilmi Yeşil
- Başkent University Faculty of Medicine, Department of Rheumatology, Ankara, Turkey
| | - Fatih Yıldız
- University of Health Sciences, Van Training and Research Hospital, Department of Rheumatology, Van, Turkey
| | - Adam Sise
- Bascom Palmer Eye Institute, Miami, USA; Miller School of Medicine, Florida, USA
| | - Vasilios Diakonis
- Bascom Palmer Eye Institute, Miami, USA; Miller School of Medicine, Florida, USA
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Türkyılmaz K, Küçükali Türkyılmaz A, Kurt A, Kurt EE, Sevim MŞ, Öner V. Investigation of tear osmolarity in early rheumatoid arthritis: relation to disease activity. Can J Ophthalmol 2013; 48:235-9. [DOI: 10.1016/j.jcjo.2013.03.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 03/28/2013] [Accepted: 03/28/2013] [Indexed: 10/26/2022]
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Relation of dry eye to disease activity in juvenile rheumatoid arthritis. Eur J Ophthalmol 2011; 22:330-4. [DOI: 10.5301/ejo.5000042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2011] [Indexed: 11/20/2022]
Abstract
Purpose To study the frequency and severity of dry eye in patients with juvenile rheumatoid arthritis (JRA) and its relation to disease activity. Patients and Methods Evaluation for dry eye was done in 40 patients with juvenile rheumatoid arthritis referred for ocular assessment in the Ophthalmology Clinics, Faculty of Medicine, Ain Shams University. They were 28 girls and 12 boys with age range of 7–12 years. Medical history, clinical examination, and full ophthalmologic evaluation were performed for each patient. The dry eye tests included tear film break-up time, Schirmer-1 test, and corneal fluorescein staining. Dry eye severity grading was used. Twenty healthy, age- and sex-matched children were assessed for dry eye as a control group. Results Thirty patients (75%) showed findings consistent with the diagnosis of dry eye. Twenty patients (50%) showed first-degree dryness, 8 (20%) showed second-degree, and 2 (5%) showed third-degree. The score of dry eye severity was significantly lower in remission compared to disease activity. Multiregression analysis showed the only factor affecting dry eye parameters was the duration of illness. Conclusions Dry eye is a common incident in children with JRA and should be screened for in all patients with this disease. Severity of eye dryness is highly correlated with the disease activity.
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Aliko A, Ciancaglini R, Alushi A, Tafaj A. Sicca symptoms, and lacrimal and salivary flow in Albanian patients with rheumatoid arthritis. J Oral Pathol Med 2010; 39:651-6. [DOI: 10.1111/j.1600-0714.2010.00899.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cury DB, Moss AC. Ocular manifestations in a community-based cohort of patients with inflammatory bowel disease. Inflamm Bowel Dis 2010; 16:1393-6. [PMID: 19998457 DOI: 10.1002/ibd.21180] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Ophthalmologic diseases in patients with inflammatory bowel disease (IBD) have been reported with varying frequency, mostly from tertiary referral centers. The aim was to describe the spectrum of ophthalmologic conditions in patients with IBD in a community setting and to compare it with a control non-IBD cohort. METHODS A prospective cohort of patients with Crohn's disease (CD), ulcerative colitis (UC), and non-IBD controls underwent evaluation by an ophthalmologist, including visual acuity, slit-lamp exam, and assessment of lacrimal output. RESULTS The ophthalmologic exam was completed in 112 subjects; 48 with CD, 40 with UC, and 24 controls. Active intestinal disease was present in 52/88 (59%) of the IBD patients, and 79/88 (89%) were taking 5-aminosalicylates (5-ASAs). The IBD and control populations had similar age and gender profiles. Patients with IBD were more likely to report ocular symptoms (odds ratio [OR] 5.6, 95% confidence interval [CI] 1.5-20), particularly dry eyes (OR 5.3, 95% CI 1.4-19), than the control population. On objective exam, 42% of IBD patients had evidence of dry eyes. In a univariate analysis, 5-ASA use was associated with an increased risk of ocular symptoms (OR 7.4, 95% CI 0.9-64), and 5-ASA use >3 g per day was associated with an increased odds ratio of dry eyes (OR 15, 95% CI 1.9-122). Active disease was not associated with eye symptoms or dry eyes. Other eye conditions such as episcleritis, uveitis, or cataracts were infrequent in this cohort. CONCLUSIONS Patients with IBD in the community frequently have dry eyes. This is associated with 5-ASA use, particularly doses >3 g per day. Whether this is a surrogate marker of disease severity is unclear.
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Affiliation(s)
- Dídia Bismara Cury
- Center of Bowel Inflammatory diseases, Clinica Scope, Campo Grande-MS, Brazil.
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Kotaniemi KM, Salomaa PM, Sihto-Kauppi K, Säilä HM, Kauppi MJ. An evaluation of dry eye symptoms and signs in a cohort of children with juvenile idiopathic arthritis. Clin Ophthalmol 2009; 3:271-5. [PMID: 19668578 PMCID: PMC2709023 DOI: 10.2147/opth.s4916] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To determine the prevalence of dry eye symptoms and signs in children with juvenile idiopathic arthritis (JIA). PATIENTS AND METHODS A total of 192 children with JIA: 48 oligo-, 39 extended oligo-, 79 polyarthritis, and 26 with other types of arthritis (eight juvenile spondyloarthritis, five juvenile psoriatic arthritis, three mixed connective tissue diseases, two systemic onset arthritis, and eight undetermined arthritis) were interviewed for dry eye symptoms and tested with Schirmer test with anesthetic. Two thirds of the patients were female and the mean age of the patients was 13.1 years (range 10-16) and the mean duration of arthritis was six years (SD 4, 4). Thirty-one percent of the patients had a history of uveitis. Dry eye was defined as Schirmer test score </= 5 mm in five minutes. The type of arthritis, a history of uveitis, and the ocular and systemic medication used were evaluated for their correlation with dry eye symptoms and signs by using chi-square tests and the Mann-Whitney Monte Carlo analysis. RESULTS Altogether 17% of this cohort had decreased basal tear secretion. The most common symptoms of dry eye were discharge secretion, itching, and watering. The intensity of symptoms and signs did not correlate. The type of arthritis, a history or presence of uveitis, and the medication used did not correlate with the occurrence of dry eyes. CONCLUSION Dry eye symptoms and signs are common in JIA, and Schirmer test with anesthetic is a useful tool in evaluating these patients.
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Affiliation(s)
- Kaisu M Kotaniemi
- Department of Ophthalmology, Rheumatism Foundation Hospital, Pikijärventie 1, FI-18120 Heinola, Finland.
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Semple R, Newcombe LW, Finlayson GL, Hutchison CR, Forlow JH, Woodburn J. The FOOTSTEP self-management foot care programme: are rheumatoid arthritis patients physically able to participate? Musculoskeletal Care 2009; 7:57-65. [PMID: 18800356 DOI: 10.1002/msc.142] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The FOOTSTEP self-management foot care programme is a clinical and cost-effective programme for basic foot care in the elderly. The aim of this study was to determine if patients with rheumatoid arthritis (RA) would be physically able to participate. METHODS A consecutive cohort of RA patients undergoing podiatry care underwent tests for sight, reach and grip strength to determine their physical ability to undertake self-managed foot care. RESULTS Thirty RA patients (10 male, 20 female), with a median age of 61 years (range 42 to 84) and disease duration of 10 years (range one to 40), were recruited. All patients passed the sight test, whereas the reach and grip tests were passed by 77% and 67% of patients, respectively. Only 57% of patients passed all the physical tests. Patients who failed the physical tests were older, and had longer disease duration and higher physical disability, pain and general health scores but these were not statistically different. CONCLUSIONS Just over half the patients in this present cohort may be physically able to undertake some aspects of self-managed foot care, including nail clipping and filing, callus filing and daily hygiene and inspection.
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Affiliation(s)
- R Semple
- Division of Podiatric Medicine and Surgery, School of Health and Social Care, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK.
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Ostör AJK. Abatacept: a T-cell co-stimulation modulator for the treatment of rheumatoid arthritis. Clin Rheumatol 2008; 27:1343-53. [PMID: 18670735 DOI: 10.1007/s10067-008-0964-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2008] [Accepted: 06/24/2008] [Indexed: 12/31/2022]
Abstract
Rheumatoid arthritis (RA) is a debilitating autoimmune disease that has traditionally been treated with disease-modifying anti-rheumatic drugs (DMARDs). In the European Union (EU), patients who fail to respond to traditional DMARDs may receive tumor necrosis factor-alpha (TNF-alpha) antagonists. However, approximately one-third of patients fail TNF-alpha antagonists due to adverse effects or lack of efficacy, and there are limited treatment options available to these patients. As knowledge of the underlying immunopathology of RA evolves, new strategies for inhibiting the inflammatory process have emerged. It is well known that activated T cells play a key role in orchestrating the immunopathological mechanisms of RA. Inhibiting the full activation of T cells is a rational strategy in the treatment of RA and represents a novel method of inhibiting disease activity, distinct from inflammatory cytokine blockade. Here, the safety and efficacy of abatacept, a selective T-cell co-stimulation modulator recently approved in the EU, is reviewed in patients with RA who have shown an inadequate response to TNF-alpha antagonists. In a randomized, placebo-controlled, double-blind, phase III trial of patients with an inadequate response to TNF-alpha antagonism, abatacept was effective in improving the signs and symptoms of RA, as well as patient-centered outcomes, such as fatigue, disability, and other mental and physical aspects of health-related quality of life. These improvements were sustained through 2 years during the open-label, long-term extension period. In this trial, abatacept demonstrated a safety and tolerability profile similar to placebo. Taken together, these data suggest that selective co-stimulation modulation with abatacept may be a viable option for patients who are refractory to both traditional therapies and TNF-alpha antagonists.
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Affiliation(s)
- Andrew J K Ostör
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
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Gladman DD, Brown RE. Pharmacoeconomics of adalimumab for rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and Crohn’s disease. Expert Rev Pharmacoecon Outcomes Res 2008; 8:111-25. [DOI: 10.1586/14737167.8.2.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Kitas GD, Hale ED, Treharne GJ. Research in Musculoskeletal Care: the Dudley interdisciplinary experience. Musculoskeletal Care 2007; 5:98-101. [PMID: 17542044 DOI: 10.1002/msc.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
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