Синдром сухого глаза у пациентов с подагрой

Abstract

Purpose. To determine and study the features of the development of dry eye syndrome (DES) in gout, depending on urate-lowering therapy, the duration of the gout disease and the concentration of uric acid in the tear. Material and methods. The study involved 149 male patients (261 eyes) aged 35 to 75 years (mean age 60.63 ± 11.00 years). Among them, 110 people (202 eyes) with an established diagnosis: "Cataract with concomitant gout disease" and 39 people (59 eyes) with cataracts without clinical and laboratory signs of gout. All patients underwent both standard ophthalmological examinations and special ones. The concentration of uric acid in tears was determined by high performance liquid chromatography (HPLC). The diagnosis of gout was confirmed according to the criteria recommended by ACR / EULAR (2016). Results. In patients with gout who do not take a urate-lowering drug, DES occurs more often (82.1%) than in patients without gout (23.1%). With an increase in the concentration of uric acid in the tear, there is a high tendency to a shortening of the tear film rupture time (strong correlation coefficient r=-0.51, p<0.001) and to a decrease in tear production (Schirmer I test) (strong correlation coefficient r=-0.59, p<0.001). Conclusion. The data obtained indicate clear changes in the functional parameters of total tear production (Schirmer I's test) and the stability of the pre-corneal tear film (Norn's test) in patients with gout. This can be considered as a fact of the predisposition of this category of patients to the development of DES. A strong dependence of changes in tear production and HRVP on the concentration of uric acid in the tear was established. There is an obvious need for additional examination of this category of patients and an adequate choice of therapy, as well as the timely appointment of "artificial tear" drugs. Key words: dry eye syndrome, uric acid, gout.