Patients with gout show tear function alterations and conjunctival change: Study

Turkey:  Gout patients had greater ocular surface changes as measured by conjunctival impression cytology (CIC) and tear function abnormalities, finds a new study conducted by Selman Belviranli and the team.

Gout is a lesser-known risk factor for dry eye disease, but this inflammatory arthritis is becoming more common as the population ages. Clinicians may discover dilated conjunctival vessels in gout patients, as well as symptoms produced by the presence of monosodium urate crystals (MSU) in the preclinical ocular environment. 

The purpose of this study was to compare the tear functions and conjunctival impression cytology (CIC) findings of gout patients to healthy controls. The findings of this study were published in the journal of Eye and Contact lens, on 20th August 2021.

This cross-sectional study comprised 34 gout patients (group 1) and 32 age- and gender-matched healthy people (group 2). The Schirmer 1 test, tear breakup time (TBUT), Ocular Surface Disease Index (OSDI) score, and CIC grade were all assessed and compared between groups.

In terms of gender and age, there was no statistically significant difference between the groups. The mean Schirmer 1 test results in group 1 was considerably lower than that in group 2. The TBUT in group 1 was likewise substantially lower than in group 2. Group 1 had a substantially higher OSDI score than Group 2. Despite the fact that 10 patients (29.4%) in Group 1 had a CIC grade of 2 to 3, none of the controls had a CIC grade of 2 to 3. Group 1 had a substantially higher mean CIC grade than Group 2.

MSU crystals can form in a patient's joints as well as tissues outside the joints when uric acid levels are high. MSU crystals have been seen in the periocular and ocular areas, but how frequently they go unnoticed by standard clinical testing is uncertain. According to this research, the eye has "poor solvent capacity" for MSU and a lower temperature. "Because investigations on ocular surface findings in gout patients are scarce," the researchers say, "clinicians' knowledge of this issue should be improved."

Reference:

Belviranli, S., Turk, H. B., Oltulu, P., Turk, N., Mirza, E., Küçük, A., Aydemir, H., & Oltulu, R. (2021). Tear Function Alterations and Conjunctival Impression Cytology Findings in Patients With Gout. In Eye & Contact Lens: Science & Clinical Practice: Vol. Publish Ahead of Print. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1097/icl.0000000000000832