SAT0308 Prospective observational study on ocular involvement in patients affected by moderate to severe psoriatic arthritis
Authors: C. Canofari, M.S. Chimenti, P. Conigliaro, F. Sunzini, P. Triggianese, G. Draghessi, F. Ambrifi, A.G. Salandri, M. Cesareo, R. Perricone
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Psoriatic Arthritis (PsA) is a chronic inflammatory arthritis typically often associated to several comorbidities. The presence of eye involvement in terms of uveitis is well known in PsA patients while retinal abnormalities and dry eye need to be characterised <h3>Objectives</h3> The aim of the study was to analyse subclinical retinal abnormalities and dry eye in a cohort of PsA patients who were naïve to biologic treatments <h3>Methods</h3> In a prospective cross-sectional study, consecutive PsA patients without clinical eye involvement were enrolled (time frame January 2017-December 2017). Joint disease activity and ESR and CRP were measured. Functional and morphological eye assessment included: complete ophthalmological examination, ocular surface disease index (OSDI), Schirmer test, BUT, spectral-domain optical coherence tomography (SD-OCT), standard automated perimetry (SAP, measured as mean defect – MD – and pattern standard deviation – PSD), and fundus perimetry (FP). Data were compared to findings from the eyes of 24 age/sex matched healthy controls (HC). <h3>Results</h3> A total of 58 eyes from 29 PsA patients (21 women and 8 men; age 52.7±13.3 years) and 48 eyes from HC (14 women and 10 men; age 47.6±15 years) were evaluated. Overall, most of the PsA patients showed a normal Schirmer test, with the exclusion of three patients (10.3%). PsA patients showed abnormal OSDI in 55.2% and lower BUT in compared to HC (p&lt;0.001, Fig.1A). ESR resulted positively correlated with OSDI (p&lt;0.001, r=0.6, Fig.1B), and negatively related with Schirmer test (p=0.005, r=−0.5, Fig.1C) and BUT (p=0.04, r=−0.4, Fig.1D). In the PsA group, SAP tests showed a lower MD (p&lt;0.0001) and a higher PSD (p=0.0043) in comparison with the HC. The latter PSD analysis resulted positively correlated with ESR (p=0.01; r=0.5) and CRP values (p=0.001; r=0.4). FP mean differential sensitivity and FP mean defect values were lower in PsA patients with respect to HC (p&lt;0.0001 for both the comparisons, figure 1E-F) and resulted negatively correlated with the age (p=0.03 r=−0.4 for both the correlations, figure 1G-H). SD-OCT in the posterior pole (superior and inferior hemifields) did not reveal differences for the mean retinal thickness between PsA patients and HC. <h3>Conclusions</h3> Intriguingly, an impairment in quality of tear film in PsA patients was observed compared to HC. The correlation between ESR and dry eye tests may be explained with a potential relationship between systemic inflammation and sicca syndrome. Interestingly, PsA patients showed a retinal functional impairment by reduced retinal sensitivity measured by MD, FP mean differential sensitivity and FP mean defect values. To our knowledge this is the first study investigating eye function and morphology in PsA patients. Further studies are needed to confirm and explain these results. <h3>Disclosure of Interest</h3> None declared