Lens changes in alopecia areata

Alterations in Corneal Sensitivity, Staining and Biomechanics of Alopecia Areata Patients: Novel Findings in a Case-Control Study

Background: A higher prevalence of ophthalmological alterations in systemic inflammatory diseases has been demonstrated. Objectives: Our objectives were to determine anterior segment findings and corneal properties in alopecia areata (AA). Methods: This is a case-control study. Severe AA patients (Severity of Alopecia Tool > 50%) and non-AA subjects underwent a general ophthalmological examination, a Pentacam and Corvis scheimpflug technology examination (Oculus Optikgeräte GmbH, Wetzlar, Germany). Visual acuity, refractive error, corneal aesthesiometry, and biomechanical and topographic variables were registered. Results: In total, 25 AA patients (50 eyes; 50.6 ± 8.1 years) and 29 controls (58 eyes; 49.4 ± 8.6 years) were included. AA patients had decreased corneal sensitivity, more corneal staining, and a more advanced cataract (p ≤ 0.004). The anterior topographic flat meridian, mean anterior keratometry, and maximum keratometric point were increased in AA (p ≤ 0.040), while pachymetry values were thinner (p ≤ 0.001). Keratoconus index and Belin/Ambrosio-enhanced ectasia total deviation display were increased (p ≤ 0.007). Two eyes with a topographic diagnosis of keratoconus and four eyes with subclinical keratoconus were detected in AA. Applanation lengths were smaller in AA (p ≤ 0.029). The Corvis Biomechanical Index was increased in AA (p = 0.022). Conclusions: AA patients have reduced corneal sensitivity and increased corneal staining. Topographic and biomechanical parameters are altered, and there could be a higher risk of keratoconus, thus possibly requiring routine ophthalmological examination.

The ocular surface findings in alopecia areata patients: clinical parameters and impression cytology

PURPOSE

The objective of this study was to examine the effects of alopecia areata (AA) on the ocular surface and conjunctival cytology.

METHODS

A total of 48 subjects were included in the present study. Twenty-three subjects were assigned to group 1 as the patient group, and 25 healthy individuals were included in group 2 as the control group. The ocular surface examination was performed, and the right eyes of all participants were included in the analysis. Both groups underwent the following tests for evaluation of ocular surface: tear break-up time (TBUT), Schirmer I test, Ocular Surface Disease Index (OSDI), and conjunctival impression cytology (CIC). Results obtained from the tests were then analyzed and compared between the groups.

RESULTS

The mean TBUT value was significantly lower in Group 1 compared to Group 2 (4.96 ± 3.4 vs 10.52 ± 4.8 s) (p < 0.001). There was no significant difference between Group 1 and Group 2 in terms of the mean Schirmer I test score (p = 0.129). The mean OSDI score was higher in Group 1 compared to Group 2 (15.48 ± 10.4 vs 9.61 ± 13.4), but the difference between both groups was not statistically significant (p = 0.1). The mean CIC score was statistically significantly higher in Group 1 than in Group 2 (1.65 ± 0.7 vs 0.52 ± 0.5) (p < 0.001).

CONCLUSION

The results of this study showed that AA was correlated with significant disturbances in conjunctival cytology and the tear function.

Juvenile versus maturity-onset alopecia areata--a comparative retrospective clinical study

We report a retrospective study of 209 patients presenting with alopecia areata (AA) at our skin department during the period 1969-1987, with special reference to possible associations, aetiological factors and the relevance of additional investigations. The patients were divided into two groups: (I) those in whom AA developed during childhood; (II) those in whom AA developed in adult life (greater than or equal to 16 years). The aim of this study was to establish whether there is a difference between juvenile and maturity-onset AA and to consider the value of additional investigations in AA. Juvenile AA is more severe and has a less favourable prognosis than the maturity-onset disease. Statistically significant differences between the two groups were not found with respect to AA type and prevalence of auto-antibodies. Bad prognostic signs in AA were early age of onset, atopy (or first-degree family history) and ophiasis and/or onychodystrophy. Initial thyroid function testing seems advisable in patients with AA. Additional valuable investigations may include hair-root examination, determination of antibodies against thyroid tissue, and serum zinc levels. There are indications that psychosomatic factors may play a role in AA. In our study, psychosomatic factors were found in 29% of the juvenile AA and in 17% of the maturity-onset AA patients.