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Anton M Kolomeyer, Ashwinee Ragam, Natasha V Nayak, Sergio Schwartzman, David S Chu; Ocular Manifestations in Patients with Psoriasis and Psoriatic Arthritis.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5312.
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To describe ocular findings in patients with Psoriasis and Psoriatic arthritis.
Retrospective chart review of ocular manifestations in patients with Psoriasis (n=3) and Psoriatic arthritis (n=4). Data was collected on age, gender, ethnicity, length of follow-up, associated autoimmune disease, ocular manifestations and surgeries, systemic immunomodulating agents, ocular medications, and visual acuity (VA).
Seven patients (12 eyes) were included (mean ± SD age, 53.1 ± 19.6 years; 57% female; 57% Caucasian; mean ± SD follow-up, 57.4 ± 61.0 months). Five (71%) patients had an associated systemic autoimmune disease (Rheumatoid arthritis [n=3] and Sarcoidosis [n=2]). All seven patients were on systemic immunomodulating agents (mean ± SD number, 2.1 ± 1.2; range, 1-4). Four (57%) patients required topical corticosteroid therapy (mean ± SD number, 1.8 ± 1.0; range, 1-3). Mean initial and final Snellen VA was 20/83 and 20/77, respectively. Ocular manifestations included panuveitis (n=6 [50%]); scleritis (n=3 [25%]); keratitis, corneal melt, inflammatory glaucoma, uveitic cataract, uveitic papillitis, pigmentary retinopathy, and iritis (n=2 [17%] each); and perforated ulcer, peripheral ulcerative keratitis, epiretinal membrane, and phthisis (n=1 [8.3%] each). Two (29%) patients underwent surgical procedures for these complications; one had a bilateral cataract extraction-intraocular lens placement and a unilateral glaucoma drainage implant, while another received a bilateral conjunctival resection with glue or patch grafting.
The breadth and severity of ocular manifestations in patients with Psoriasis and Psoriatic arthritis are underrecognized. These involve the anterior and posterior segments, and require systemic and topical therapy to control. Further studies are necessary to characterize the long-term effects of ocular disease in patients with Psoriasis and Psoriatic arthritis.
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