Ocular findings in patients with psoriasis: Is it related to the side effects of treatment or to psoriasis itself? A case-control study.

OBJECTIVES: To assess ocular abnormalities in psoriatic patients (new-cases vs. patients under treatment) in comparison with healthy controls.

METHODS: A total of 200 psoriatic patients and 100 healthy controls were enrolled in this prospective, observational study. The demographic data of the individuals were recorded. Dermatological and ophthalmological examinations were conducted; ocular surface disease index (OSDI), Schirmer and tear break-up time (TBUT) values were also measured.

RESULTS: The mean values of TBUT and Schirmer tests in patients were significantly lower than the controls and significantly higher scores of OSDI were observed among patients compared to the controls (p<.0001); dry eye disease was more frequent in the patients than the healthy subjects (p=.001). Other ocular findings including cataract and uveitis were not significantly different between the groups. Although no significant differences were found between the ocular findings of new cases and patients under treatment, ocular findings in cases under treatment were associated with the type of treatment and more frequent in those treated with methotrexate, followed by acitretin and biologic drugs.

CONCLUSIONS: Ocular surface problems in psoriatic patients are more common than previously thought; in addition to the role of treatment modalities, psoriasis itself and a probable systemic inflammation may play an important role.

KEY POINTS: There are limited case-control studies about ocular manifestations in psoriasis and also its pathogenesis is not yet clear. This study shows that ocular surface problems in psoriatic patients are higher than healthy subjects; in addition to the role of treatment modalities, psoriasis itself and a probable systemic inflammation may play a pivotal role. Regular ophthalmological evaluations are recommended in psoriatic patients especially those with more severe and chronic form of the disease, to prevent any complications.