Ocular involvement in patients with psoriasis and psoriatic arthritis

Abstract

Introduction. Ocular involvement in patients with psoriasis are a serious problem due to permanent structural changes that are associated with decreased visual acuity in people of working age. Psoriatic arthritis could lead to ocular findings in approximately 10% of patients. It's difficult to find an optimal treatment method considering the variety of mechanisms and immune factors that are involved in the pathogenesis of the disease. TNF inhibitors have revolutionized the evolution of patients with psoriatic uveitis, but the accessibility of this treatment is a matter of time. Aim of the study. Establishing the frequency of ocular involvement in patients with psoriatic arthritis and determining the effectiveness of different methods of treatment. Materials and methods. This review was based on the literature findings from 1976 to 2017. This procedure led to an overall of 17 original articles that were used to support this study. This study consists of a summary of our current knowledge in the pathogenesis and treatment of patients with psoriasis and ocular findings. Results. It has been found that people with psoriatic arthritis and severe forms of psoriasis have a higher risk of uveitis compared with control group. Conjunctivitis has a prevalence of 19,6%, followed by uveitis (7-25%), iritis (7,1%), dry eye syndrome and episcleritis. Pathogenetic treatment is the most efficient in these patients. New agents like TNF inhibitors have placed traditional treatment method with corticosteroids on the second place. Adalimumab is effective in 68% of patients, and remission was maintained in 39% of patients after one year of treatment. On the other way, it has a high rate of adverse reactions, like pulmonary embolism, congestive heart failure etc. Conclusions. 1. Patients with psoriatic arthritis have a higher risk of developing ocular complications compared to simple forms of psoriasis. 2. Uveitis is a common complication in patients with psoriatic arthritis and has a high recurrence rate. 3. TNF inhibitors are the most effective method of treatment in psoriasis to the detriment of corticosteroids.