Caracterización y prevalencia del compromiso ocular en pacientes con enfermedad autoinmune y autoinflamatoria en un centro de referencia reumatológica en Colombia entre los años 2000 a 2015
Thesis
Objectives: To estimate the prevalence of various ocular diseases occuring in the context of an autoimmune disease in patients from a rheumatology clinic referral center in Colombia, according to clinical features and socio-demographic factors from 2000 to 2015.Methods: We conducted an observational, descriptive prevalence study. Randomized stratified sampling with proportional assignment was carried out using Epidat 3.4. Data analysis was fulfilled through SPSS v22.0. Categorical variables were subjected to univariate analysis. Measures of central tendency were performed for cuantitative variables.Results: Ocular involvement was present in 634 patients (38,65%). Excluding patients with Sjögren´s syndrome (SS) and dry eye, which account for 100% (by definition, dry eye is present in all patients with SS), ocular involvement was present in 222 patients (13,53%). 83,3% subjects were women. Rheumatoid arthritis (RA) posed the greatest eye disease prevalence (62,2%), sarcoidosis the lesser (10%). Keratoconjunctivitis sicca (KCS) was the most common ophthalmic manifestation (63,5%) in all autoimmune diseases except the spondyloarthropaties. Out of 414 patients with SS and KCS, additional eye disease was present on 8 individuals, the most common being uveitis (10,6%). The highest prevalence of corticosteroid drug usage (88,8%) was present in patients with cataract (4.1% of the total population). 28 of 222 (12,6%) patients had uveitis. 16 (7,2%) of the total patients (and 18,75% of the total patients with Systemic lupus erythematosus –SLE- ) had ocular toxicity due to antimalarial drugs. Antinuclear antibodies were present in the whole vascular retinal disease group. The highest anti-DNA antibody serum positivity was present in patients with episcleritis; accordingly, SLE rendered the highest episcleritis prevalence (12,5%). 22% of anti-RNP positive patients presented scleritis. 32,1% of uveitis patients were HLA-B27 positive. Eye manifestations preceded systemic involvement in 11,1 to 33,3% of patients.Conclusions: Eye disease is present with relative frequency in Colombian patients with autoimmune disease (38,65%), RA being the condition with the highest prevalence (62,2%) and KCS being the most prevalent ocular manifestation (63,5%). 12,6% of patients had uveitis. On occasion, eye disease can precede systemic compromise. Eye examination should be included as part of these patient population assessment because it is a frequent co-morbidity. In addition, rheumatic drug ocular adverse effects should be monitored during the course of treatment.
