Rheumatoid Factor Positivity and Ocular Manifestations among Rheumatoid Arthritis Patients - A Hospital-Based Cross-Sectional Study

Abstract

BACKGROUND RA Factor positivity is one of the criteria for diagnosis of Rheumatoid arthritis. High levels of rheumatoid factor (generally above 20 IU/mL. 1:40 or over the 95th percentile) are indicative of Rheumatoid arthritis (present in 80 %). Rheumatoid Factor positivity is associated with more severe and more active disease and extraarticular disease. This study was done in Rheumatoid arthritis patients to assess the proportion of ocular manifestations in them and also an association between RF positivity and ocular manifestation and treatment-related ocular complications among Rheumatoid arthritis patients. METHODS A cross-sectional study was conducted among the patients attending the rheumatology clinic at Government Medical College, Trivandrum. Patients in the age group of 18-60 years who satisfied the American Rheumatism Association criteria were selected for the study and all of them underwent complete ophthalmic examination as well as RA Factor assessment by latex agglutination. The qualitative variables were expressed in proportion. The chi-square test was used to determine the association between qualitative variables. RESULTS A total of 67 RA patients were screened of which 26 (38.8 %) had ocular manifestations and among the total patients, 57 (85 %) were rheumatoid factor positive. Among the total patients with ocular manifestations, 24 (92 %) patients were rheumatoid factor positive. The association between RF positivity and ocular manifestation was found to be statistically not significant (P-value -0.33). In the present study, no other treatment-related ocular complications were seen except for one patient on long term steroids who had subcapsular cataract. CONCLUSIONS The presence of the RA factor does not show a positive association with the occurrence of ocular manifestation and the use of a low dose of methylprednisolone and DMARDs in RA has reduced the incidence of steroid-related complications. The more commonly used DMARDs -methotrexate, salazopyrin and hydroxychloroquine were found to be safe since no drug toxicity was noted in the present study. KEY WORDS RA Factor, Rheumatoid arthritis, Ocular Manifestation.