Ocular surface disorders affect quality of life in patients with autoimmune blistering skin diseases: a cross-sectional study

Huanmin Kang; Mengbo Wu; Jianing Feng; Yuerong Ren; Yingyi Liu; Wen Shi; Yingqian Peng; Yixin Tan; Ruifang Wu; Guiying Zhang; Yan He

doi:10.1186/s12886-022-02663-w

Ocular surface disorders affect quality of life in patients with autoimmune blistering skin diseases: a cross-sectional study

BMC Ophthalmol. 2022 Nov 15;22(1):437. doi: 10.1186/s12886-022-02663-w.

Authors

Huanmin Kang^#^{1

2}, Mengbo Wu^#^{1

2}, Jianing Feng^{1

2}, Yuerong Ren^{1

2}, Yingyi Liu^{1

2}, Wen Shi^{1

2}, Yingqian Peng^{1

2}, Yixin Tan³, Ruifang Wu³, Guiying Zhang³, Yan He^{4

5}

Affiliations

¹ Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
² Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan, China.
³ Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
⁴ Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China. yanhe6416@csu.edu.cn.
⁵ Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan, China. yanhe6416@csu.edu.cn.

^# Contributed equally.

Abstract

Background: Autoimmune blistering skin diseases (AIBD) are a group of rare chronic autoimmune diseases which are associated with ocular surface diseases especially dry eye disease. This study is designed to investigate the relationship between ocular surface disorders and quality of life among patients with autoimmune blistering skin diseases.

Methods: Twenty-four AIBD patients (18 pemphigus and 7 pemphigoid) and twenty-five non-AIBD controls were included. Ocular surface disease index (OSDI), ocular surface evaluation, including slit-lamp examination, Schirmer I test, tear break-up time, corneal fluorescein staining, lid-parallel conjunctival folds, meibomian gland evaluation, presence of symblepharon and corneal opacity were assessed. Life quality was evaluated by multiple questionnaires, including Medical Outcomes Study 36-Item Short Form Questionnaire (SF-36), Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI) and Health Assessment Questionnaire-Disability Index (HAQ-DI). Ocular surface tests and quality of life were compared between AIBD patients and non-AIBD controls. In the AIBD patients, the associations between ocular surface parameters and quality of life were also evaluated.

Results: 92% of AIBD patients and 87.5% of age- and sex-matched non-AIBD controls were diagnosed with dry eye in this study. Compared with non-AIBD controls, AIBD patients reported lower SF-36 scores (P < 0.05) and severer OSDI, Schirmer I test, tear break-up time, corneal fluorescein staining, presence of symblepharon and corneal opacity measures (P < 0.05). OSDI, Schirmer I test were correlated with SF-36 composite scores or scores on the SF-36 subscales.

Conclusions: AIBD patients experience reduced quality of life and more severe ocular surface disorders including dry eye, symblepharon and corneal opacity. Early treatments of dry eye and collaborations among multidisciplinary physicians are necessary in patients with AIBD.

Keywords: Autoimmune skin diseases; Dry eye; Ocular surface; Quality of life; Questionnaire.

MeSH terms

Autoimmune Diseases* / complications
Blister
Corneal Opacity*
Cross-Sectional Studies
Dry Eye Syndromes* / diagnosis
Eyelid Diseases* / diagnosis
Fluorescein
Humans
Meibomian Glands
Quality of Life
Skin Diseases*
Surveys and Questionnaires
Tears

Substances

Fluorescein