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Franziska Wolf, Marc Schargus, Martin Feuchtenberger, Gerd Geerling; Correlation of Tear Film Osmolarity and Rheumatic Disease Activity in Patients with Rheumatoid Arthritis. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3787.
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© ARVO (1962-2015); The Authors (2016-present)
Tear film osmolarity has been heralded as a new diagnostic tool with improved sensitivity and specificity in the diagnosis of dry eye. Rheumatoid arthritis is associated with secondary Sjögren’s Syndrome (SS). Our prospective study aimed to assess correlations between tear film osmolarity and parameters of rheumatoid disease.
From March to June 2009 a group of 87 patients with rheumatoid arthritis with (n=30) and without dry eye (n=57) was examined including the measurement of tear film osmolarity. Rheumatoid disease activity was determined with the gold standard, Disease Activity Score DAS28. This is calculated based on erythrocyte sedimentation rate, the number of joints swollen and sensitive to pressure and the patient's self assessment. Cut off values for hyperosmolarity of 316 and 312 mOsm/L were tested. The higher value from measuring both eyes was used for analysis. Chi Square test and Cramer contigency coefficient were calculated to determine the dependency of DAS28 (n=74) and osmolarity. Spearman correlation tests were performed to determine a correlation between RF (n=79), CRP (n=82) and osmolarity.
A significant correlation was found in DAS28 and osmolarity with a cut off value of 316 mOsm/L (Chi square test p=0,016). The Cramer contingency coefficient was V=0,335 (p=0,016). The relationship in three severity codes of DAS28 and osmolarity with a cut off value of 312 mOsm/L was not significant (Chi Square test p=0,078). The Spearman correlation coefficient of r=-0,104 in osmolarity and CRP was not considered significant (p=0,353), as well as the coefficient of r=0,138 in osmolarity and RF (p=0,226).
Tear film osmolarity does not correlate with CRP or RF but with the rheumatic disease activity score DAS28 with a cut off value of 316 mOsm/L. The new tear film osmolarity measurement is fast and easy to perform even for non ophthalmologists. Hence, osmolarity seems to be a new appropriate component in the diagnosis or monitoring of rheumatoid arthritis.
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