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Anton M Kolomeyer, Ashwinee Ragam, Natasha V Nayak, Christina Yu, Sergio Schwartzman, David S Chu; Characterization of Ophthalmic and Rheumatologic Features in Patients with Psoriasis and Psoriatic Arthritis. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5784.
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© ARVO (1962-2015); The Authors (2016-present)
To characterize and describe ophthalmic and rheumatologic findings.
Retrospective chart review of ophthalmic and rheumatologic manifestations in patients with psoriasis (n=6) and psoriatic arthritis (n=15) from two tertiary care centers in the United States specializing in autoimmune ophthalmic disease. Data was collected on age, gender, ethnicity, associated autoimmune disease, visual acuity (VA), intraocular pressure (IOP), type and grade of inflammation, ocular and rheumatologic characteristics of disease, systemic immunomodulating agents, and ocular therapy.
Twenty-one patients were included (mean ± SD age was 51.1 ± 14.4 years; mean follow-up, 48.5 months; 76% were female; and 86% were Caucasian). Six (29%) patients had an associated systemic disease (three each with sarcoidosis and rheumatoid arthritis). None of the eyes experienced a change in Snellen VA by two or more lines. Mean ± SD initial and final IOP was 14.6 ± 4.4 mm Hg and 14.5 ± 4.1 mm Hg, respectively. Ocular manifestations included anterior uveitis (n=9 [43%]), panuveitis (n=5 [24%]), scleritis (n=4 [19%]), peripheral ulcerative keratitis (n=2 [9.5%]), retinal vasculitis (n=1 [4.8%], and multifocal choroiditis (n=1 [4.8%]). Most common patterns of musculoskeletal involvement were oligoarthritis (n=7 [33%]), polyarthritis (n=3 [14%]), and axial (n=2 [9.5%]), while three (14%) had no articular involvement. All patients required systemic immunomodulatory therapy, with 11 (52%) requiring more than one agent.
Psoriasis and psoriatic arthritis resulted in a wide variety of chronic anterior and posterior segment inflammation, the most common of which was anterior uveitis. The oligoarticular form of psoriatic arthritis was the most likely to result in the development of ophthalmic disease. Presence of associated systemic autoimmune disease was common. The majority of patients required more than one immunomodulatory agent to achieve inflammation control.
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