ĐẶC ĐIỂM LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ TỔN THƯƠNG BỀ MẶT NHÃN CẦU Ở BỆNH NHÂN VIÊM KHỚP DẠNG THẤP

Abstract

Rheumatoid arthritis (RA) is most common systemic autoimmune disease that have ocular manifestations including ocular surface damage. Purpose: To describe the clinical characteristics and evaluate the treatment outcomes of ocular surface involvement in patients with RA. Materials and methods: A prospective descriptive study was conducted on RA patients who were examined and received treatment at the Cornea Department of the National Eye Hospital from October 2019 to December 2021. All patients underwent a comprehensive clinical examination, including the OSDI, TBUT, Schirmer’s test, ocular surface staining. Medical treatment and surgical treatment was realised and the evaluation of treatment outcomes was noted. Results: 18 patients with an average age of 57.18 years. The female-to-male ratio was 3.5/1. The duration of RA was more than 5 years in 13 cases and less than 5 years in 5 cases. Four cases had joint complications, while 14 cases did not. Nine cases were undergoing systemic treatment, while 9 cases had not received complete treatment. Dry eye was present in 100% of the patients, 3 patients having central corneal ulcers and 6 patients having peripheral ulcerative keratitis. There were no cases of scleritis and episcleritis. Conclusion: Ocular surface damage in RA include hyposecretion dry eye and peripheral ulcerative keratitis. Filamentous keratitis and peripheral corneal ulcers or corneal perforation can develop in complicated severe cases. The severity of the symptoms correlates with the age and duration of RA, but does not correlate with the severity of arthritis. Systemic treatment is an important factor in determining treatment outcomes and prognosis.