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THU0127 The severity of keratoconjunctivitis sicca in rheumatoid arthritis correlates with the medical outcome study 36-item short form health survey (SF-36) score but not the disability index (HAQ-DI)
  1. R.O. Akintayo1,
  2. B.H. Olaosebikan2
  1. 1Department of Medicine, University of Ilorin Teaching Hospital, Ilorin
  2. 2Medicine, Lagos State University Teaching Hospital, Ikeja, Nigeria


Background Keratoconjunctivitis sicca (KSC) is the most frequent ocular manifestation of rheumatoid arthritis (RA). It is highly heterogenous and exhibits a considerable variability of presentation. Whereas a significant proportion of patients with KCS may be asymptomatic; it is unknown if the degree of dryness of the eyes, irrespective of symptomatology, has an association with the overall quality of life and functional ability.

Objectives To determine the correlation between the Schirmer’s score and the Medical Outcome Study 36-Item Short Form Health Survey (SF-36) score as well as the disability index measured by the Health Assessment Questionnaire-Disability Index (HAQ-DI).

Methods A total of 50 Nigerian patients satisfying the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for RA were studied. Tear production was measured by unstimulated 5 min Schirmer’s test (using 5 mm by 35 mm Whatman filter paper) and ocular staining with flourescein stain. Each patient also completed the SF-36 and HAQ-DI questionnaires.

Results The mean age of the patients was 47.2±12.5 years. Among them, 42 (84%) were females, giving a female-to-male ratio of 5.25:1. Rheumatoid factor and anti-citrullinated protein antibody were positive in 38 (76%) and 30 (60%) patients respectively. KCS was found in 15 (30%) patients among whom only 6 patients were symptomatic for dry eyes. The mean visual acuity [LogMAR (Snellen equivalent)] among the patients with and without KCS were 0.70 (6/30) and 0.10 (6/7.5). Among all patients, there was a positive correlation between the mean Schirmer’s score (between each patients two eyes) and the Physical Component Summary (r=0.292, p=0.008) as well as the Mental Component Summary (r=0.228, p=0.030) of the SF-36. There is however no significant correlation between the mean Schirmer’s score and the HAQ-DI (r=0.148, p=0.188).

Conclusions Ocular manifestation is very common in RA and KCS is particularly rampant. Even in asymptomatic patients, the degree of xerophthalmia may give a reliable insight into both the physical and mental quality of life but not into the degree of functional disability.

References [1] Vignesh APP, Srinivasan R. Ocular manifestations of rheumatoid arthritis and their correlation with anti-cyclic citrullinated peptide antibodies. Clin Ophthalmol2015;9:393–7.

[2] Bron AJ, Tomlinson A, Foulks GN, et al. Rethinking dry eye disease: a perspective on clinical implications. Ocul Surf2014;12(2):S1-S31.

Disclosure of Interest None declared

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