Ocular Reactions during Chronic Inflammatory Rheumatisms

Aims: To describe the ophthalmological lesions observed during chronic inflammatory rheumatism to help improve the management of visual function.

Study Design: This was a prospective study.

Place and Duration of Study: The study was carried out at the University Hospital Centre of Brazzaville from June 1st, 2016 to May 31st, 2017.

Methodology: The study involved 40 patients who were followed in the Rheumatology Department and oriented in Ophthalmology to assess ocular involvement. The usual criteria used in rheumatology have made it possible to diagnose rheumatic diseases. These patients were hospitalized or followed by an outpatient rheumatologist. Ophthalmologic examination was performed at least once for all patients and included a measure of best corrected visual acuity, automatic tonometer eye tone, shirmer test, biomicroscopy. Baseline examination was eye after dilation with mydriatic eye drops at indirect ophthalmoscopy.

Results: Of the 40 patients with chronic inflammatory rheumatism, 12 were men and 28 were women. The average age was 40.8 years (range: 10–58 years). The pathologies included systemic lupus in 20 cases (50%), rheumatoid arthritis in 10 cases (25%), spondyloarthropathy in 6 cases (15%), scleroderma in 2 cases (5%), juvenile arthritis idiopathic in 1 case (2.5%) and Behçet's disease in 1 case (2.5%) Twenty-two patients (55%) had ocular involvement. The lesions were unilateral in 14 cases, consisting of uveitis (n = 11), including 7 anterior and 3 posterior cases and 1 case of panuveitis; dry syndrome (n = 8) with keratoconjunctivitis sicca (6 cases) and conjunctivitis sicca (2 cases), and scleritis (n = 3). Three cases of complicated cataract were associated with anterior uveitis. Seven patients had visual acuity ≤ 2/10 in at least one eye and 2 cases had bilateral blindness.

Conclusion: Ocular lesions are commonly associated with rheumatic diseases. These lesions are dominated by uveitis in its anterior form and are seen mainly in spondyloarthropathy. Dry syndrome occurs in rheumatoid arthritis and lupus. The lesions can be silent and require appropriate detection and treatment to prevent eye complications and sequelae.