Psoriasis Associated With Structural and Functional Changes to the Cornea

Patients with psoriasis should undergo routine eye examinations due to corneal structural and functional changes and these features should be considered prior to undergoing intraocular surgeries. These findings, from a prospective, comparative, cross-sectional study, were published in Photodiagnosis and Photodynamic Therapy.

Patients (n=53) who were referred for an eye examination at Sivas Cumhuriyet University in Turkey after receiving a diagnosis of psoriasis underwent a complete ophthalmologic examination. Eye features were compared with 53 matched healthy controls.

For the patients with psoriasis, the most common type was plaque psoriasis (83%) and most (57%) had mild disease severity.

Among the entire study population, patients had a mean age of 34.9±12 years and 64% were women. Compared between groups, the psoriasis group had significantly different Schirmer 1 (mean, 16.2 vs 22.2 mm; P <.001) and tear break up time (mean, 8.3 vs 9.6 sec; P =.02) test results, respectively.

The investigators did not detect significant differences between patients with psoriasis and controls with regards to corneal topographical, aberrometric, anterior segment, or densitometry measurements (all P >.05).

They did observe differences in corneal endothelial cell characteristics, in which the psoriasis cohort exhibited significantly increased standard deviation of cell area (mean, 206.4 vs 183.2 μm²; P =.006), average cell area (mean, 426.6 vs 403.2 μm²; P =.01), and coefficient of variation of the cell area (mean, 48.1 vs 45.7 μm²; P =.04) but had a decreased endothelial cell density (mean, 2389.9 vs 2512.4 cells/mm²; P =.02) compared with controls, respectively.

This study may have been limited by grouping all patients with psoriasis together and not assessing the influence on corneal characteristics due to differing subtypes of psoriasis or anti-rheumatic treatment modalities.

“Corneal structural and functional changes, particularly endothelial alterations, are of utmost importance in planning intraocular surgeries such as cataract and glaucoma surgery in patients with psoriasis,” investigators explain.

Reference

Yeter DY, Boxali E, Apa AS, Tosun M. Analysis of corneal densitometry and endothelial morphometry in patients with psoriasis. Photodiagnosis Photodyn Ther. 2021;36:102522. doi:10.1016/j.pdpdt.2021.102522