Ocular Involvement in Systemic Autoimmune Diseases

Elena Generali, Luca Cantarini, Carlo Selmi

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

Eye involvement represents a common finding in patients with systemic autoimmune diseases, particularly rheumatoid arthritis, Sjogren syndrome, seronegative spondyloarthropathy, and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. The eye is a privileged immune site but commensal bacteria are found on the ocular surface. The eye injury may be inflammatory, vascular or infectious, as well as iatrogenic, as in the case of hydroxychloroquine, chloroquine, corticosteroids, and bisphosphonates. Manifestations may affect different components of the eye, with episcleritis involving the episclera, a thin layer of tissue covering the sclera; scleritis being an inflammation of the sclera potentially leading to blindness; keratitis, referring to corneal inflammation frequently associated with scleritis; and uveitis as the inflammation of the uvea, including the iris, ciliary body, and choroid, subdivided into anterior, posterior, or panuveitis. As blindness may result from the eye involvement, clinicians should be aware of the possible manifestations and their management also independent of the ophthalmologist opinion as the therapeutic approach generally points to the underlying diseases. In some cases, the eye involvement may have a diagnostic implication, as for episcleritis in rheumatoid arthritis, or acute anterior uveitis in seronegative spondyloarthritis. Nonetheless, some conditions lack specificity, as in the case of dry eye which affects nearly 30 % of the general population. The aim of this review is to elucidate to non-ophthalmologists the major ocular complications of rheumatic diseases and their specific management and treatment options.

Original languageEnglish (US)
Pages (from-to)263-270
Number of pages8
JournalClinical Reviews in Allergy and Immunology
Volume49
Issue number3
DOIs
StatePublished - Dec 1 2015
Externally publishedYes

Keywords

  • ANCA-associated vasculitis
  • Biologics
  • Rheumatoid arthritis
  • Spondyloarthritis
  • Systemic lupus erythematous
  • Uveitis

ASJC Scopus subject areas

  • Immunology and Allergy

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