Ocular manifestations in rheumatoid arthritis patients in Bangladesh: A cross-sectional study

Objectives: The objectives of this study are to determine the prevalence and pattern of ocular involvement and their association with demographic and serological factors in rheumatoid arthritis (RA) patients at a tertiary care hospital in Bangladesh. Materials and Methods: This descriptive cross-sectional study enrolled 141 adult RA patients at a tertiary care hospital in the southeastern region of Bangladesh from November 2021 to October 2022. Demographics, disease duration, Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) status, erythrocyte sedimentation rate, C-reactive protein, and Disease Activity Score in 28 joints (DAS-28) were recorded. Comprehensive ophthalmic examinations were done. The main outcome measures were the prevalence and types of ocular manifestations. Results: Participants had a mean age of 48.4 ± 11.6 years, most were aged 40–59 years (63.8%) and female (83.0%; 117/141). The mean RA duration was 7.6 ± 6.6 years. The median DAS-28 was 4.5 (interquartile range 3.4–5.6) with 41.1% (58/141) showing moderate and 39.7% (56/141) high disease activity. Ocular involvement occurred in 65.2% (92/141) of patients. Dry eye disease (DED) was the most common, affecting 51.1% (72/141), followed by episcleritis (8.5%), scleritis (4.3%), and keratitis (1.4%). DED was significantly associated with age <40 years (92.6% vs. 41.1% in ages 40–59; P < 0.001). No significant associations were found between ocular manifestations and sex ( P = 0.574), RF ( P = 0.220), or anti-CCP status ( P = 0.737). Conclusion: Ocular involvement, particularly DED, is highly prevalent among RA patients in Bangladesh. The lack of significant association with serological markers suggests that ocular disease occurs independently of autoantibody status.