Rheumatoid Arthritis: Díaz-Valle D

Benítez Del Castillo JM, Díaz-Valle D, Pato E, López-Abad C, Alejandre N. · Unidad de superficie e inflamación ocular, Hospital Clínico San Carlos, Madrid 28040, Spain. · An Sist Sanit Navar. · Pubmed #19169297 links to  free full text

Abstract: Ocular inflammation is a common clinical manifestation related to several autoimmune systemic disorders, specially spondyloarthropaties. In this group, there are different clinical diseases that are related to special uveitic patterns. Several discriminative patterns have been defined that closely link uveitis with certain systemic or ophthalmic diseases. Unilateral recurrent anterior acute uveitis is the most frequent form of uveitis related to spondyloarthropaties, and is sometimes the initial manifestation of an undiagnosed spondyloarthropaty. The collaboration of ophthalmologists, rheumatologists and internal medicine specialists is very important for the correct management and treatment of these patients.

Benítez-Del-Castillo JM, Acosta MC, Wassfi MA, Díaz-Valle D, Gegúndez JA, Fernandez C, García-Sánchez J. · Hospital Clínico San Carlos, Madrid, Spain. · Invest Ophthalmol Vis Sci. · Pubmed #17197530 links to  free full text

Abstract: PURPOSE: An alteration in corneal innervation has been described in dry eye associated with diabetes mellitus, contact lens use, and LASIK. The purpose of this study was to evaluate whether dry eye not related to Sjögren's syndrome (NSDE) and dry eye related to primary Sjögren's syndrome (PSDE) are associated with an alteration of the corneal nerves and sensation. METHODS: Twenty-one patients with dry eye (10 NSDE and 11 PSDE) and 20 healthy volunteers were studied. Healthy volunteers were divided into two groups: one younger than 60 years (N<60) and the other 60 years of age or older (N> or =60). The study of the epithelium, stroma, and subbasal corneal nerves was performed with a confocal microscope. Mechanical, chemical, and thermal sensation was evaluated using the Belmonte noncontact esthesiometer. RESULTS: A statistically significant decrease in the number and density of subbasal nerves (P < 0.0001) and the density of superficial epithelial cells (P < 0.0001) was observed in dry eyes. The number and density of subbasal nerves was higher in the N<60 group. A significant decrease was found with respect to mechanical, chemical, and thermal sensitivity (P < 0.0001). Sensibility was better in the healthy eyes. A strong correlation was found between the density of superficial epithelial cells and the nerves and between the number and density of subbasal nerves and sensation (P < 0.001). CONCLUSIONS: The use of confocal microscopy and noncontact esthesiometry allow the detection of the presence of corneal neuropathy in patients with dry eye.

Díaz-Valle D, Miguélez Sánchez R, Fernández Espartero MC, Pascual Allen D. · Unidad de Inflamación Ocular, Hospital General de Móstoles, Madrid, Spain. · Arch Soc Esp Oftalmol. · Pubmed #15306969 links to  free full text

Abstract: CASE REPORT: A 48-year old woman diagnosed with rheumatoid arthritis 10 years previously, developed severe anterior scleritis in the right eye (RE) refractory to conventional treatment. The patient was treated with 3 intravenous doses of Infliximab achieving complete remission of the scleral inflammation within four weeks. DISCUSSION: The use of Infliximab, a blocker of tumour necrosis factor (TNFalpha) could be an alternative approach to the management of refractory scleritis, but further long-term investigations would be necessary to evaluate their safety and efficacy.