Spectrum of and Factors Associated with Eye Disorders among Rheumatoid Arthritis Patients Attending Tertiary Hospital in Uganda

Abstract

Eunice Headcraph,1 Immaculate Atukunda,1 Mark Kaddumukasa,2 Lydia Nakiyingi,2 Rebecca Claire Lusobya,1 Anne Ampaire-Musika,1 Caroline Otike,3 Elizabeth Nagawa,1 Paul Juma,1 Fransisco Msonge,1 Juliet Otiti-Sengeri1 1Department of Ophthalmology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda; 2Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda; 3Clinical Epidemiology Unit, School of Public Health, College of Health Sciences, Makerere University, Kampala, UgandaCorrespondence: Eunice Headcraph, Department of Ophthalmology, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda, Tel [phone], Email [email protected]: Ocular morbidities associated with rheumatoid arthritis (RA) have not received much attention in Africa, particularly in sub-Saharan Africa. They are among the commonest (40%) extra-articular organ involvement in RA. If undiagnosed, there is a potential risk of them causing visual impairment or blindness. There is no documented study in Uganda on the magnitude of eye disorders among RA patients.Aim: To determine the spectrum of eye disorders and associated factors among patients with RA attending Mulago National Referral Hospital.Methods: A hospital based cross-sectional study was conducted among adults with RA attending the rheumatology clinic between July 2021 and September 2021. Clinical and sociodemographic data were collected, and ophthalmologic examinations were performed on all consenting participants. Modified Poisson regression with robust standard error was used to determine factors associated with eye disorders.Results: Overall, 105 patients with RA were enrolled, of which, 53 (50.5%) had eye disorders. The commonest disorder (54.7%, n=29) was dry-eye syndrome. Factors that were significantly associated with eye disorders were age 36– 55 years (aPR 1.56, p=0.015), duration of RA > 5 years (aPR 1.81, p=0.001), use of hydroxychloroquine > 5 years (aPR 1.77, p=0.041), dose of oral steroids > 10 mg/day (aPR 1.49, p=0.034), and history of both diabetes and hypertension (aPR 1.87, p=0.014).Conclusion: The prevalence of eye disorders among patients with RA was high, with the commonest being dry-eye syndrome. We recommend that ocular examinations be performed on every patient at the time of RA diagnosis for early detection of eye disorders.Keywords: rheumatoid arthritis, eye disorders, sub-Saharan Africa

Keywords

• rheumatoid arthritis
• eye disorders
• sub-saharan africa.