Abstract
Objective Rheumatoid Arthritis and other rheumatic diseases may present with ocular manifestations. The purpose of our work was to determine the prevalence and type of eye involvement in rheumatoid arthritis and other connective tissue diseases through a meta-analysis and literature review.
Methods A systematic review of the literature was performed using Medline, Web of Science, and the Cochrane library from their inceptions until January 7, 2019. Conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, choroid hemorrhage, blindness and amaurosis fugax were searched for prevalence in patients with rheumatoid arthritis, systemic lupus erythematosus, antiphospholipid syndrome, dermatomyositis, polymyositis, systemic sclerosis, Sjogren’s syndrome, undifferentiated connective tissue disease, giant cell arteritis, granulomatosis polyangiitis (GPA; formerly Wegener's granulomatosis), systemic vasculitis, and sarcoidosis.
Results 3394 studies were identified and 65 included. The prevalence of eye involvement was 18% in rheumatoid arthritis, 31% in systemic lupus erythematosus, 35% in antiphospholipid syndrome, 27% in giant cell arteritis, 26% in GPA and 27% in sarcoidosis. The most common manifestations was dry eyes (keratoconjunctivitis sicca) in most diseases analyzed with a frequency approaching 90% in Sjogren’s syndrome. Anterior and posterior uveitis were the most common OC in sarcoidosis occurring in 16 [3-28]% and 6 [3-9]% of patients respectively.
Conclusion Eye involvement is present in approximately one fifth of rheumatoid arthritis patients, and one quarter to one third of patients with connective tissue diseases (other than Sjogren’s syndrome at 90%) and vasculitis.
