Background Rheumatoid arthritis (RA) may affect any organ of the body and display a broad spectrum of clinical and immunological manifestations. Ocular involvement has been described less commonly and includes involvement by mucocutaneous disease, secondary Sjogren’s syndrome, neuro-ophthalmic lesions, and retinal vascular disease.
Objectives The aim of our study was to analyse the possible association between the presence of antiphospholipid antibodies (aPL) and retinal lesions detected by means of prospective ophthalmologic examination in a series of RA patients.
Methods Sixty-eight female RA patients attending our Extra-articular Involvement RA Clinic were studied. All patients fulfilling the 1987 American Rheumatism Association Criteria for adult RA. Ophthalmologic examination included assessment of best corrected visual acuity, tonometry, slit-lamp bimicroscopy, and fundus examination. Serologic studies included determination of anticardiolipin antibodies (aCL) (ELISA) and Lupus Anticoagulant (LA) (Coagulation Test).
Results Retinal vascular disease was detected in 7 (10%) of 68 RA patients. The retinal lesions consisted of retinal vascular occlusion in two patients (one arterial and one venous thrombosis), cotton-wool sports in one, optic disc oedema in two cases, retinal haemorrhages in one, and ischaemic optic neuropathy in one case. aPL were detected in 5 (71%) of these 7 patients: four had aCL and one had LA. When compared with patients without retinal vascular disease, patients with retinopathy had a higher prevalence of aPL (71% vs 6%); p = 0.0001).
Conclusion Retinal vascular disease may be frequent in patients with RA. The presence of aPL may be associated with a higher prevalence of retinal abnormalities in RA patients.