Evaluation of the frequency of dry eye and sjogren's syndrome in patients with rheumatoid arthritis and correlation between dry eye and rheumatoid arthritis activity

Rheumatoid arthritis is the most common inflammatory arthritis. Keratoconjunctivitis sicca, scleritis, and episcleritis are ocular complications of this disease. The aim of this study is to evaluate Sjogren’s syndrome in subjects with rheumatoid arthritis. In this cross-sectional study, ninety patients diagnosed as rheumatoid arthritis that followed up in rheumatology clinic of Rasool Akram hospital for six months and no definite cause was found for their dry eye, enrolled in the study. Rheumatoid arthritis activity was evaluated by DAS28 index and the severity of dry eye was assessed by Japanese dry eye diagnostic criteria. Mean activity of disease according to DAS28 was 2.9±1.56 and 88.9% of patients had dry eye based on Japanese dry eye diagnostic criteria. Twelve patients (13.3%) had secondary Sjogren's syndrome. SSA antibody was positive in 13.3% patients and 10% patients had positive SSB antibody. There was significant correlation between rheumatoid arthritis activity based on DAS28 and severity of dry eye according to Japanese dry eye diagnostic criteria in the both Sjogren (p=0.045) and non Sjogren groups (p=0.001). We found significant correlation between rheumatoid arthritis activity and dry eye in the both sjogren and non-Sjogren groups. Most of rheumatoid arthritis subjects do not have Sjogren’s syndrome but dry eye is common even in rheumatoid arthritis patients without Sjogren's syndrome.