Abstract

AbstractPurpose To examine the density and the distribution of corneal Langerhans cells (LCs) and to compare the results with dry‐eye related parameters in rheumatoid arthritis (RA).Methods 52 RA patients (mean age: 58 [49‐66]) with various degree of disease activity and 24 healthy subjects (mean age: 61 [52.5‐67]) were enrolled. Central and peripheral LC number and morphology were assessed with in vivo confocal laser corneal microscopy. In addition, lid parallel conjunctival folds (LIPCOF), tear break up time (TBUT), Schirmer’s‐test (ST), and ocular surface disease index (OSDI) were also evaluated. .Results The prevalence of central and peripheral LCs and the central LC morphology values (LCM) were higher in RA compared to controls (median [interquartile range]: 42.50 [22.95‐93.50] vs 10.00 [0.00‐42.33] cell/mm2, 98.00 [62.00‐154.5] vs 59.50 [45.25‐94.75] cell/mm2, and 2.00 [1.00‐2.00] vs 1.00 [0.25‐1.00], respectively, p<0.05 for all). Within the RA group, LC prevalence and morphology were not affected by disease activity. However, patients on anti‐TNF or corticosteroid therapy exhibited LCM and central and peripheral LC density comparable to controls. TBUT values were lower and OSDI scores were higher in RA than in controls (9.00 [7.00‐12.00] vs 12.00[9.00‐14.00] seconds and 20.00 [10.93‐38.21] vs 9.75 [4.93‐16.28], respectively, p<0.05 for all). ST results were comparable in RA and controls.Conclusion Dendritic cell accumulation and maturation in the corneal center suggest the involvement of the cornea in RA, even in patients in inactive stage and without ocular symptoms.

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