Background/Purpose: Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that primarily affects synovial joints but may also involve extra-articular organs. Ocular involvement is one of the most common extra-articular manifestations and may result from disease activity or treatment-related complications. The aim of this study was to describe the ophthalmologic manifestations in a cohort of patients with RA and to evaluate their association with sociodemographic and disease-related characteristics.

Methods: A cross-sectional, observational, descriptive and analytical study was conducted. Consecutive patients ≥ 18 years old with RA (2010 ACR/EULAR criteria) were included. Sociodemographic data, disease characteristics, history of ocular involvement and current treatment were recorded. All patients were asked to complete the Ocular Surface Disease Index (OSDI) and underwent a comprehensive ophthalmologic evaluation performed by the same specialist, including tear break-up time (TBUT), Schirmer’s test, slit-lamp biomicroscopy, fundoscopy and intraocular pressure measurement. Descriptive statistics were used to summarize results. Associations between ocular dryness severity and clinical variables were analyzed using Chi-squared and Spearman correlation tests. A p-value ≤ 0.05 was considered statistically significant.

Results: A total of 50 patients were included. Patient’s characteristics are shown in Table 1. Fifty percent reported previous sicca symptoms, with xerophthalmia being the most frequent (46%). Sjögren’s syndrome associated with RA was identified in 6% of patients. The median OSDI score was 8.3 (IQR 4.2–38.0), classifying 40% of patients as having moderate-to-severe ocular dryness. Ophthalmologic examination revealed xerophthalmia in 94% of cases (78% mild, 12% moderate, 4% severe). Cataracts were observed in 46% of patients, with nuclear cataracts accounting for 32%. All ophthalmologic evaluations are detailed in Table 2. Patients with moderate-to-severe dryness based on OSDI had significantly higher disease activity by DAS28 (p = 0.025) and SDAI (p = 0.018).

Conclusion: In our cohort of RA patients, the most frequent ocular manifestation was xerophthalmia, which was mild in 78% of cases. Cataracts were present in 46% of patients, with the nuclear subtype being the most common. Moderate-to-severe dry eye symptoms were associated with higher disease activity. These results highlight the importance of identifying ocular symptoms in RA and suggest that ocular surface involvement may reflect a higher systemic inflammatory burden.

« Back to ACR Convergence 2025

ACR Meeting Abstracts - https://acrabstracts.org/abstract/frequency-and-characteristics-of-ophthalmologic-involvement-in-patients-with-rheumatoid-arthritis/