Comparative study of diagnostic tests for dry eye disease between healthy and juvenile rheumatoid arthritis children

PURPOSE: To compare dry eye diagnostic findings in juvenile rheumatoid arthritis patients and normal children. METHODS: For this transversal study, 30 eyes of 15 patients with juvenile rheumatoid arthritis (group 1) and 22 eyes of 11 normal controls (group 2) were examined clinically and underwent tests for keratoconjunctivitis sicca: Schirmer's 1, tear film break-up time and rose bengal staining tests. RESULTS: Six children with juvenile rheumatoid arthritis presented one or more symptoms of keratoconjunctivitis sicca (40%) and five of them (83.3%) presented meibomitis or other signs of this disease. In group 2, no child presented symptoms or signs of keratoconjunctivitis sicca. Mean Schirmer test did not differ between group 1 and 2 (p=0.156). However, the mean tear film break-up time was significantly reduced in group 1 (p=0.0005) and the mean rose Bengal staining score in group 1 was significantly greater than in group 2 (p=0.0038). Five of the fifteen children of group 1 (33%) have two or more abnormal tests and were diagnosed as having definite keratoconjunctivitis sicca, while four children (26%) were labeled with probable keratoconjunctivitis sicca. No child of group 2 had more than one positive test. CONCLUSIONS: Signs and symptoms of keratoconjunctivitis sicca appear to be a common ocular finding in juvenile rheumatoid arthritis children. Although only tear film break-up time and rose bengal staining score were significantly different in these groups, there was a trend toward worsening of the other dry eye tests in juvenile rheumatoid arthritis children.

Arthritis; juvenile rheumatoid; Keratoconjunctivitis sicca; Diagnosis techniques; ophthalmological; Tears; Rose bengal; Children; Comparative study

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