Corneal Thickness Mapping in Rheumatoid Arthritis Patients Using Anterior-Segment Optical Coherence Tomography

Abstract

: Background: Ocular manifestations of rheumatoid arthritis (RA) include dry eye (DE), episcleritis, scleritis, and peripheral ulcerative keratitis (PUK). The most common form of ocular involvement is DE. Purpose: To generate corneal thickness (CT) and corneal epithelial thickness (CET) maps using anterior segment optical coherence tomography (AS¬¬-OCT) in RA patients and compare those parameters with normal subjects. Materials and Methods: A case-control study was done on 35 eyes of 18 RA patients and 25 eyes of 14 healthy individuals recruited from Benha University Hospitals. All the included cases were subjected to full history taking and ophthalmological examination. All participants were successfully imaged using AS-OCT with subsequent automated CT and CET mapping. The disease activity score (DAS-28) was calculated for RA patients. Results: RA patients had significantly thinner CT in all regions (p<0.05, p≤0.001) and their epithelium was found to be thinner in the superior and the superonasal sectors in RA with DE (RA-DE) subgroup (p=0.002 and p=0.004, respectively) than the controls. There was statistically significant positive correlation between “mean (CT, CET)” and TBUT (r=0.352, p=0.006 and r=0.493, p<0.001, respectively). There was statistically significant negative correlation between mean CET and (OSDI, disease duration, DAS, ESR) (r=-0.603, p<0.001, r=-0.468, p<0.005, r=-0.57, p=0.001 and r=-0.547, p<0.001, respectively), while the mean CT had no significant correlation with these parameters. Conclusion: RA patients had thinner CT than controls, which correlated with TBUT and thinner CET in RA-DE subgroup which correlated with all parameters (TBUT, OSDI, disease duration, DAS, ESR)